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Your quick reference guide to billing and reimbursements for telehealth services

Delivering care via a telehealth platform has now become a necessity. Whether you are new to virtual care, keeping up with changes to requirements, or both, here are must-have references for practices.

In a matter of just a few weeks, telehealth has shifted from a convenient cost-effective care option to the singular focus of healthcare delivery. For many independent private practices, the response to the COVID-19 health crisis and stay-at-home orders mark their foray into using telehealth services. For most, it’s an imperative for the health of their practice and patients.

With the right telehealth platform, seeing patients via synchronous video is both easy and efficient. But the requirements and regulations surrounding telehealth can be anything but.

Telehealth resources for healthcare practices

To help, we’ve compiled online resources we feel are valuable to practices that deliver virtual care. This is part of our continuing dedication to helping healthcare providers thrive in the midst of a very difficult period of time.

Telehealth references related to COVID-19

The AMA Quick Guide to Telehealth
A selection of resources created in fast response to the COVID-19 outbreak. Topics include an overview of telehealth services, practice implementation and workflow, policy, coding, and payment.

Medicare Provider Fact Sheet
The Centers for Medicare & Medicaid Services (CMS) breaks down revised Medicare coverage and payment of virtual services, following the expansion of telehealth with the new 1135 waiver. This includes how telehealth visits are defined and covers other online communications with patients.

Updated telehealth policies in response to COVID-19
Updated state actions in response to COVID-19
The Center for Connected Health Policy (CCHP) tracks coverage policies and state-by-state changes as they occur, and has updated their findings on a daily basis when warranted. Their policy summaries include changes to Medicare, Medicaid, HIPAA, and private insurers. Their summary of state actions includes individual links to each state, making it easy to access yours in greater detail.

CMS Fact Sheet: Expansion of Accelerated and Advance Payments Program
While the COVID-19 national emergency is in effect, CMS has expanded eligibility for providers at outpatient practices to apply for three months of advance Medicare payments. This fact sheet outlines who can apply and how to request payment.

Medicaid FAQs related to COVID-19
Not limited to the topic of telehealth, this list of FAQs answers inquiries about how state agencies can respond to the health crisis.

Telehealth regulations per state for Medicaid and commercial payers (before COVID-19 changes)

Before the COVID-19 crisis, CCHP was already a key resource of telehealth regulations. Below are two CCHP reports on state policies, from October 2019.

Will regulations return to this pre-COVID-19 status after the national emergency is lifted? While it’s unlikely that all waivers will become permanent changes, this period of need has been shining a spotlight on the value and benefits of telehealth, and the essential role it can play for private practices. At PatientPop, we believe a major shift toward telehealth will occur throughout the industry following the current crisis. 

Telehealth laws and reimbursements by state, via interactive map
Complete state-by-state report: State telehealth laws and reimbursement policies (440 pages)
Includes Medicaid telehealth reimbursement, private payer laws, parity laws, and professional regulation.

Medicaid approach to telehealth
This Medicaid-published resource can help states understand policies related to paying Medicaid healthcare providers who deliver virtual care.

Regardless of your state, specialty, or payer mix, we recommend each practice reach out to their state board or association, and commercial payers, to confirm expected reimbursements and any necessary billing requirements. For efficiency, it’s best to begin with those payers who cover the highest percentage of your patient base — and refer to the resources above as a head start.

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