Medicare Telehealth Services
The Centers for Medicare and Medicaid Services (CMS) recently published policy updates related to Medicare telehealth services.
In 2019 CHS finalized the definition of remote patient monitory as the “collection of physiologic data (electrocardiogram, blood pressure, glucose monitoring) digitally stored or transmitted by the patient or caregiver to the HHA.
With the onset of the Public Health Emergency (PHE), additional policies were ushered in under the HH PPS to make providing and receiving services via telecommunications technology easier. The plan of care must describe how such technology is tied to the patient-specific needs in the comprehensive assessment.
It was also noted in 42 CFR 409.43(a) that these services cannot be substituted for a home visit ordered as part of the plan of care AND will not be considered a home visit for the purposes of patient eligibility or payment.
These rules were finalized with the CY 2021 HH PPS final rule and 42 CFR 409.469(e) was amended to include not only remote patient monitoring but other communication/monitoring services consistent with the plan of care for the individual, on the HH cost report as allowable administrative costs.
Now, this data will not just be a line item on a cost report, but will be reported on HH claims to allow CMS to analyze the characteristics of patients using services provided remotely and have a more extensive understanding of the social determinants that affect who benefits most from these services. Potential barriers to care maybe more readily identified in certain subsets of patients.
While home health providers will not be reimbursed for these services, CMS is adding new billing codes for Home Health telecommunications technology. Agencies may voluntarily report the codes now (voluntary reporting started January 1, 2023) but these must be reported beginning July 1, 2023.
Telecommunications technology will be reported on the HH claim using the following 3 G-codes:
• G0320: Home health services furnished using synchronous telemedicine rendered via a real-time two-way audio and video telecommunications system
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• G0321: Home health services furnished using synchronous telemedicine rendered via telephone or other real-time interactive audio-only telecommunications system
• G0322: The collection of physiologic data digitally stored and/or transmitted by the patient to the home health agency (for example, remote patient monitoring)
Documentation must exist in the medical record to show how the telecommunications technology helps to achieve the goals outlined on the plan of care.
Additional information can be obtained by reviewing the CR 12805 or on your MAC’s website.
MLN Matters Number MM12805
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