Telemedicine

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Due to COVID-19 there are new guidelines for telehealth services. Many insurances such as Commercial and Medicare plans have lowered the restrictions to allow providers to offer telemedicine services to their patients. This benefit is temporary for some insurances. Yes! You may be able to waive copays for your telehealth patients during this financial crisis caused by COVID-19.

Click the link for more information.

https://www.hhs.gov/hipaa/for-professionals/special-topics/emergency-preparedness/notification-enforcement-discretion-telehealth/index.html

https://oig.hhs.gov/fraud/docs/alertsandbulletins/2020/policy-telehealth-2020.pdf

Telemedicine Copay Guidelines:

Insurance payors are allowed to waive copays to promote telehealth services under the Waiver 1135 and the CARES Act. Below is a list of insurance carriers who are waiving and are not waiving copays during COVID19. Many states have laws in place to reimburse telehealth services the same as the reimbursement as a face to face appointment. Phone calls may also be reimbursed at the same rate. It is depending on the insurance and state. Telehealth appointments require either a GT or 95 modifier.

Copays waived:                                                      Copays are required:

Medicare*                                                              UHA

Blue Cross                                                                HMAA

United Health Care

Presbyterian Health Plan

HMSA

Patients or caregivers can self-report their vitals. Providers should include a note stating the vitals were not recorded in office due to the COVID-19 Emergency.

*Medicare Part B requires copays/ deductibles to be paid by the patient. The Medicare Advantage Plans are paying 100% cost share (waiving for patient)

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