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How To Bill Telehealth Services Under the 1135 Waiver

Learn How to Bill Telehealth Services Under the 1135 Waiver webcast image

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Medicare rules for coverage and payment of telehealth services have been relaxed due to the current public health emergency. This webcast —updated with new CMS guidance — explains exactly what Medicare will cover for professional claims in office, hospital, and other visits via telehealth.

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Non-Member Price: $129.00

Product Code: AI041520

Webcast Format*:

Description Biography Continuing Education

EXPANDED CONTENT: Since the original webcast, CMS has issued new guidance pertaining to provider eligibility, audio-only reimbursement, facility billing for telehealth, place of service, requirements for office visit billing and new hospital reimbursement when patients receive care under telehealth. It’s all covered in this updated webcast!

Prior to the HHS 1135 Waiver, Medicare would only pay for telehealth on a limited basis. Under this new Waiver, rules have been relaxed for professional claims to account for the restrictions on access being imposed as the country weathers the current public health emergency. But there is an abundance of confusion among providers regarding what exactly constitutes "flexibilities" on the Medicare regulations. Unfortunately, there has been much misinformation and inaccurate guidance provided to practices.

Even before the current public health emergency, telehealth was a gray area. Now, with the use of telehealth more prevalent, providers need to understand what the new rules are, what exactly are the definitions of each type of service for correct coding and billing, and how to navigate the differences in rules between the Centers for Medicare & Medicaid Services (CMS) and other payers.

During this special edition ninety-minute webcast, produced by ICD10monitor, Terry Fletcher will address the many questions that have been flooding in from physicians and physician practices, such as when you can and cannot bill an office visit for a phone call, whether you can be paid the same as if the patient came to the practice, and if virtual check-ins and digital services are still billable. Using examples of when and how to appropriately bill for telehealth services under the new 1135 Waiver, she will provide clear guidance and accurate information, enabling your physicians as well as physician practices to ensure proper reimbursement for professional claims in and access for your patients.

Why This is Relevant:

Due to the current COVID-19 pandemic, patients, particularly the elderly, are struggling to see their physicians. These patients are either showing signs and/or symptoms of the virus. They will need a virtual check in, or they are scheduled for their existing appointments and cannot travel to the office for an in-person appointment due to fear of exposure, or because local and state government officials have said most people should be staying at home and imposing a self-quarantine on themselves and family to help prevent the spread of the virus. With the HHS 1135 Waiver now in place, it is incumbent upon physicians and physician practices to fully understand what Medicare will cover for office, hospital, and other visits furnished via telehealth in order to ensure financial livelihood and access to care.

Take this brief quiz to see if you and your team could benefit from this webcast:

  1. Exactly what can you bill for a telehealth visit and are there modifiers or POS specifics?
  2. Will patients have co-pays and deductibles?
  3. Will the location of the patient matter?
  4. Are virtual check-ins and digital services still billable?
  5. Does the patient have to be established to the physician to bill for services?
  6. What does the term urgent or emergent care mean?
  7. Are you up to date with the latest telehealth billing guidance from CMS?

Learning Objectives:

  • Understand the 1135 Waiver, what exactly the "flexibilities" are during this crisis, and what it means in practical application for professional claims
  • Learn exactly what services are covered under the telehealth concept for professional claims
  • Find out patients' share of cost during this time of uncertainty
  • Learn what providers can provide telehealth services
  • Understand HIPAA concerns for the telehealth services
  • Get new CMS guidance from updates issued April 28-30

Who Should Attend:

Physicians, billers, coders, collections department, APPs, mid-level providers, schedulers, practice managers

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