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Innovations and Efficiencies in Home-Based Care: H ...
Telehealth During COVID-19_HCCI
Telehealth During COVID-19_HCCI
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Pdf Summary
The document provides detailed guidance for house call programs on the use of telehealth services, especially during the COVID-19 pandemic when telehealth reimbursement opportunities were expanded. <br /><br />### Introduction<br />Telehealth denotes the electronic exchange of medical information to improve patient health. The Centers for Medicare and Medicaid Services (CMS) have specific requirements for Medicare Telehealth Services, which were eased during the COVID-19 Public Health Emergency (PHE) to allow broader use. The PHE waivers permitted patients to receive telehealth services regardless of location and eliminated originating and distant site requirements temporarily.<br /><br />### Eligible Practitioners<br />These include physicians, nurse practitioners, physician assistants, nurse midwives, certified nurse anesthetists, clinical psychologists, licensed clinical social workers, registered dieticians, nutrition professionals, physical therapists, occupational therapists, and speech-language pathologists.<br /><br />### Virtual Care Options and Reimbursement<br />1. **Video Visits:** Conducted via two-way audio and video communication.<br />2. **Telephone Services:** Medicare pays for certain audio-only services using specific CPT codes (99441-99443) for physicians and aligned codes for non-physician practitioners.<br />3. **Other Audio-Only Services:** Include advance care planning, annual wellness visits, smoking cessation services, and various counseling services.<br /><br />### Implementation Considerations<br />1. **Informed Consent:** State-dependent; verbal consent recommended for telehealth visits.<br />2. **Physical Exams:** Limited in scope but possible through telehealth.<br />3. **Documentation Requirements:** Similar to face-to-face services, including chief complaints, history, physical exam, medical decision-making, and assessment plans.<br />4. **Privacy:** Relaxed HIPAA rules during PHE allow for various video communication platforms except for public-facing applications.<br />5. **Technology:** Handled mostly through real-time audio and video communication, with some exceptions for audio-only services.<br /><br />### Communication Technology-Based Services (CTBS)<br />Includes virtual check-ins (HCPCS G2012, G2252), remote evaluations (HCPCS G2010, G2250), and online digital E/M services (CPT 99421-99423, 98970-98972), primarily for patient-initiated communications to address acute issues without requiring in-person visits.<br /><br />### Support and Resources<br />The Home Centered Care Institute provides various resources, including hotlines, webinars, virtual office hours, tools, and tip sheets, to support home-based primary care providers. For further assistance, one can visit the HCCIntelligence Resource Center or contact via hotline and email.<br /><br />This guidance ensures house call programs can adapt to telehealth regulations and maximize care delivery efficiency during and beyond the pandemic.
Keywords
telehealth
house call programs
COVID-19
Medicare
reimbursement
eligible practitioners
virtual care
informed consent
communication technology-based services
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