Applicability of Diagnoses from Telehealth Services for Risk Adjustment (HCC) April 10, 2020

This is excellent news for risk adjustment from our friends at INDUSTRY COLLABORATION FFORT, www.iceforhealth.org

Memo from CMS regarding the submittal of diagnosis for risk adjustment that are from telehealth visits. When the visits meets all risk adjustment eligibility, then diagnoses from telehealth services can meet the risk adjustment face-to-face requirement when the services are provided using an interactive audio and video telecommunications system that permits real-time interactive communication. Simply, patient and provider need to be able to see each other for the telehealth visit.

Use place of service code “02” for telehealth or use the CPT telehealth modifier “95” with any place of service.

http://www.iceforhealth.org/library/documents/Applicability_of_Diagnoses_from_Telehealth_Services_for_Risk_Adjustment_4.10.2020.pdf

https://www.cms.gov/files/document/applicability-diagnoses-telehealth-services-risk-adjustment-4102020.pdf

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