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Telehealth Services: Billed Correctly

 The focus of this post is links on

1. Telehealth Services (PDF)

2. Medicare Claims Processing Manual Chapter 12 (PDF)

3. Medicare Coverage and Payment of Virtual Services (video)

4. Office of Inspector General (OIG)

 

1.      1. Telehealth Services Booklet

      https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/TelehealthSrvcsfctsht.pdf

 

2.    2. Medicare Claims Processing Manual Chapter 12 - Physicians/Nonphysician Practitioners (Rev. 10356, 09-18-20)

https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/clm104c12.pdf

Important information is found on the following pages:

30.6.1.1 - Initial Preventive Physical Examination (IPPE) and Annual Wellness Visit (AWV) (Rev. 3096, Issued: 10-17-14, Effective: 01-27-14, Implementation: 11-18-14)

P 32       1. Initial Preventive Physical Examination (IPPE) 

P 33        2. Annual Wellness Visit (AWV)

                The first AWV providing personalized prevention plan services (PPPS) (HCPCS G0438)

                Subsequent AWVs providing PPPS (HCPCS G0439)

P34         Who may perform IPPE or AWV

P 35        Eligibility

P 36        HCPCS codes used to bill the IPPE

P 36        HCPCS codes used to bill the AWV

P 36-37 Reporting a Medically Necessary E/M Service Furnished During the Same Encounter as an IPPE or AWV

3.    3. Medicare Coverage and Payment of Virtual Services (video)        

      https://www.youtube.com/watch?v=Bsp5tIFnYHk&feature=youtu.be

 

4.      4. Office of Inspector General (OIG) - An OIG report on CMS indicated improperly paying some telehealth claims that didn’t meet Medicare requirements (PDF)

https://oig.hhs.gov/oas/reports/region5/51600058.pdf

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Location: San Diego, CA, USA

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