Latest Update: Although APTA staff stated a telephone could be used during the March 20, 2020 Facebook Live event to conduct an e-visit under Medicare, we have received conflicting information from the MACs as it relates to the requirement of an online portal for an e-visit. We advise members to confirm the requirements with their MAC(s). We are continuing to work with CMS to get definitive guidance. We apologize for the confusion.
COVID-19 Pandemic and the Physical Therapy Practice
In addition to a revised e-visit FAQ published this afternoon (http://www.apta.org/
- March 20, 2020, Update: APTA has developed two template letters to use in advocating to states — your governor, state representatives, and Medicaid office director — for coverage by private payers and Medicaid of telehealth furnished by PTs and PTAs to ensure that patients continue to have access to the rehabilitative care they need amid the COVID-19 pandemic. One letter is for individual PTs and PTAs; the other letter is for state chapters. Instructions are included at the top of each letter.
- March 18, 2020, Update: APTA to host a live webinar on “Medicare “E-visits” March 19 at 8:00 pm, ET and a Facebook Live event on Friday, March 20 at 2:00 pm, ET.
- March 17, 2020, Update: APTA has developed a template letter for you to use in advocating to your payers — private, Medicare Advantage, and Medicaid (both fee for service and MCOs) — for coverage of telehealth furnished by PTs and PTAs to ensure that patients continue to have access to the rehabilitative care they need amid the COVID-19 pandemic. Instructions are included at the top of the letter.
- March 16, 2020, Update: Telehealth in Physical Therapy In Light of COVID-19
The use of telehealth is one approach that can help keep both patients and providers safe, but PTs and PTAs need to understand the current regulatory and payer telehealth landscape to decide whether telehealth is right — or even a possibility — for them.
Recommendations for Determining Potential for Physical Therapists to Provide services via Telehealth
There is currently a great deal of confusion around the coverage of telehealth when provided by physical therapists. Some broad policies and federal and state legislation may be interpreted as including physical therapists even though this is not explicitly stated. Also, when members call a payer and ask if telehealth is covered the payer may respond yes not knowing that it is a physical therapist asking the question or what codes the physical therapist intends to bill. To that end we are providing guidance on how to pose the question and/or how to interpret communications from federal and state agencies as well as payers.
For example Anthem has advised APTA that there has been no change in policy related to physical therapists and telehealth at this point in time. One of our members shared the following information.
“This is what Anthem Colorado just told CPTN ( = Colorado Physical Therapy Network: 110 clinics):
“We will process claims in compliance with the member’s benefit documents and our policies and procedures. Therefore, if the therapist feels that offering PT/OT/ST as telehealth services is within the scope of their license and in compliance with applicable state and federal laws, then appropriate, clean claims should be submitted for processing.
This response has many caveats and conditions. Any references to scope of license and all state and federal laws relevant to telehealth would have to be reviewed before moving forward with providing and billing PT services via telehealth.
When posing the question to a payer or state agency we recommend that physical therapists be very specific and get the following information in writing.
- Will services provided by physical therapists be covered when provided via telehealth.
- If so, what codes should be billed and what modifiers are required?
- What device(s) or application(s) can be utilized?
- What, if any, consents are required?
- Are there any special documentation requirements?
Reposted from APTA Updates.