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CMS expands telehealth billing opportunities in nursing facility setting

You can take advantage of greater frequency when reporting telehealth services to patients in the nursing home setting. CMS will soon begin to permit payment for encounters once every 14 days, instead of once per month.
CMS issued Change Request 10716 on April 6. The transmittal amends Chapter 12 of the Medicare Claims Processing Manual, making it possible for providers to double the virtual visits they provide patients in a nursing facility on a more frequent basis. Previously, providers were limited to a single telehealth visit during every 30-day span.
Effective Jan. 1, 2021, for claims processed after July 6, 2021, providers can report any of the four subsequent nursing facility visit codes – 99307, 99308, 99309, 99310 provided via telehealth every 14 days.
When conducting a telehealth visit, providers should bill the codes with the GT (Via interactive audio and video telecommunication systems) or GQ (Via asynchronous telecommunications system) modifier or with place of service code 02, according to instructions from CMS.
Of the nursing facility codes, providers reported 99308 most often, according to 2019 Medicare claims data, the most recent available. That year, providers reported nearly 12 million claims for 99308, returning more than $566 million in reimbursement.
It remains to be seen whether the telehealth billing leniency will endure past the end of the COVID-19 public health emergency (PHE). Expect further clarification from CMS as the PHE draws to a close.
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