The Centers for Medicare and Medicaid (CMS) has several recent changes beginning January 1, 2024. These changes included CPT codes, HCPCS code, telehealth service provider and an additional location for telehealth services. Medicare Telehealth services include CPT codes 0591T – 0593T for health and well-being coaching services, which we are adding on a temporary basis and HCPCS code G0136 for Social Determinants of Health Risk Assessment, which we are adding on a permanent basis.
With, the temporary expansion of the scope of telehealth originating site of service to now include a person’s home as an originating site with the U. S. Telehealth practitioner types expand to occupational therapists (OTs), physical therapists (PTs), speech-language pathologists (SLPs), and audiologists. Also adding mental health counselors (MHCs) and marriage and family therapists (MFTs) as distant site practitioners for purposes of providing telehealth services.
CMS gives clarification of modifier ’95’ stating it should be used when the clinician is in the hospital and the patient is in the home, as well as for outpatient therapy services provided via telehealth by PT, OT, or SLPs. While, delaying the requirement for an in-person visit with the physician or practitioner within 6 months prior to initiating mental health telehealth services, and, again, at subsequent intervals as the Secretary determines appropriate, as well as similar requirements for RHCs and FQHCs. The continued coverage and payment of telehealth services included on the Medicare Telehealth Services List (as of March 15, 2020) until December 31, 2024.
Layman terms: For health and well-being coaching services CPT codes 0591T – 0593T, was added on a temporary basis. Also, for Social Determinants of Health Risk Assessment, HCPCS code G0136 was added on a permanent basis. Telehealth services provided to people in their homes are now allowed and payable at the non-facility PFS rate. Clarification was given to modifier ’95’ and should be used when the clinician is in the hospital and the patient is in the home, as well as for outpatient therapy services provided via telehealth by PT, OT, or SLPs. Including mental health counselors (MHCs) and marriage and family therapists (MFTs) as distant site practitioners for purposes of providing telehealth services.
Applies to Provider Types: Occupational therapists, physical therapists, speech-language pathologists, audiologists, mental health counselors, and marriage and family therapists.
Applicable year: 2024
Location: Office Place of Service 11
Example: Speech Therapist Ross, sees patient XXXX a 4-year-old little girl who is present on camera with her mother for difficulty in articulating words and promote improved communication skills. Today we focused on speech clarity, word pronunciation, this is helping patient XXX to increase her vocabulary and encourage verbal expression. Telehealth visit lasted 30 minutes 92507 x 2 with 95 modifier is billed by Speech Therapist Ross.
Stay tuned for forthcoming updates on the impending changes slated to go into effect in 2024. If you require assistance in preparing your practice for these transitions, don’t hesitate to reach out to us directly. At Neolytix, we are always poised to support your practice with top-notch services, including medical billing, coding, and revenue cycle management.
Our medical billing services are not only comprehensive but also fully compliant with HIPAA standards, administered by a team of certified professionals. Additionally, our medical credentialing services boast rapid processing, efficiency, and meticulous organization, following stringent workflow management procedures. Feel confident in relying on Neolytix for all your practice’s needs.