Updated CMS Guidance Provides Parity in Payment for Telephone Services
Today, CMS announced that it will provide parity in payment for telephone services. Specifically, Medicare payment for the telephone evaluation and management visits would be equivalent to Medicare payment for office/outpatient visits with established patients retroactive to March 1, 2020. This would increase payments for these services from a range of about $14-$41 to about $46-$110.
ASE applauds CMS’s efforts to continue to provide more support for providers in the fight against COVID-19. This change in policy had been a priority for ASE and the Alliance of Specialty Medicine. Recently, as part of the Alliance, we sent CMS a letter highlighting the need for this change to support physician practices as they seek to deliver medically necessary care under unprecedented conditions.
The guidance updated today provides temporary regulatory waivers and new rules to maximize the flexibility in the response to COVID-19.
Telephone Evaluation, Management/Assessment and Management Services, and Behavioral Health and Education Services
- A broad range of clinicians, including physicians, can now provide certain services by telephone to their patients.
- Medicare payment for the telephone evaluation and management visits (CPT codes 99441-99443) is equivalent to the Medicare payment for office/outpatient visits with established* patients effective March 1, 2020.
- E/M codes must be reported with modifier 95, or CMS will pay the “current” rates of $14-$41.
- When clinicians are furnishing an evaluation and management (E/M) service that would otherwise be reported as an in-person or telehealth visit, using audio-only technology, practitioners may bill using these telephone E/M codes provided that it is appropriate to furnish the service using audio-only technology and all of the required elements in the applicable telephone E/M code (99441-99443) description are met.
- Using new waiver authority, CMS is also allowing many behavioral health and education services to be furnished via telehealth using audio-only communications.
Click here for the full list of telehealth services notes which services are eligible to be furnished via audio-only technology, including the telephone evaluation and management visits.
*ASE is seeking clarification from CMS if this change includes new patients