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Telehealth Update: CMS Increases Telehealth Access via Phones

Wednesday, May 6, 2020  
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The Centers for Medicare and Medicaid Services (CMS) is now allowing certain services to be provided via telephone. APA is actively seeking guidance on how to bill an E/M code and a psychotherapy service when done together at a visit, which is not currently permissible by audio only because the E/M codes a psychiatrist would use have not yet been added to the audio-only list. Once APA has clarification from CMS, more information will be shared via APA's website.  Members are encouraged to ask questions through APA's practice management helpline at practicemanagement@psych.org

New CMS Changes to Billing for Audio Only – Retroactive to March 1, 2020:

On April 30, 2020, CMS issued a new ruling permitting audio only telephone care for the following psychiatry codes: 90785, 90791, 90792, 90832, 90833, 90834, 90836, 90837, 90838, 90839, 90840, 90845, 90846, 90847, 90853. CMS also announced they will be increasing payments for audio-only telephone visits (99441, 99442, 99443) between Medicare beneficiaries and their physicians to match payments for similar office and outpatient visits. This would increase payments for these services from the current range of about $14-$41 to the higher range about $46-$110, and the payments are retroactive to March 1, 2020.

Since the add-on psychotherapy codes, 90833, 90836, and 90838 have been permitted for just audio, we believe CMS is recognizing it will be acceptable to bill for an E/M with one of these codes even when only audio is available using the point of service for where the encounter would have taken place were it not for the public health emergency, and the modifier 95 is to be used to indicate the care was provided via telemedicine. We are waiting for confirmation from CMS that this is the case and will update this page as needed.

Practice Guidance for COVID-19 (link)

APA News Release (5/1/20) APA Praises CMS Action to Increase Telehealth Access via Phones (link)