State vs. Federal Telemedicine Updates

In order to further assist our members, NYSPA has put together a chart outlining several legal and practice issues relating to telemedicine, both from a state and federal perspective.  To view the chart, please click here.

TELEMEDICINE UPDATE

On June 24, 2021, Governor Cuomo declared an end to the New York State COVID-19 disaster emergency.  The following is a summary of current New York laws and regulations that impact the delivery of telemedicine.    

June 18, 2020 Telepsychiatry Webinar & Slides

Presented by: Rachel Fernbach, Esq.

Frequently Asked Questions on Telepsychiatry

Last updated: July 2, 2020

The below questions and answers reflect some of the most commonly asked questions regarding telepsychiatry - before, during and after the COVID-19 public health emergency.  Please check back regularly for updates. Please feel free to submit additional questions to [email protected] 

Medicare Audio Only Fees

Audio Only E/M Codes - Locality 1
Audio Only E/M Codes - Locality 2
Audio Only E/M Codes - Locality 3
Audio Only E/M Codes - Locality 4
Audio Only E/M Codes - Locality 99

Urgent Telemedicine Update

The Centers for Medicare & Medicad Services has announced that additional emergency measures have been put into place to temporarily expand the use of telemedicine. These measures will include allowing providers to conduct telemedicine visits with patients who are located in their homes. The provider must use an interactive audio and video telecommunications system that permits real-time communication between the distant site (i.e., physician's office or other location) and the patient at home.

New Telemedicine Billing Instructions

CMS Updates
CMS has updated its original instructions for billing for telemedicine services. 

►        Use Place of Service 11 for telemedicine services provided to patients located in their own homes, with modifier 95.  This will be paid at the usual office/outpatient visit fee.

Coding and Billing Update for Telemedicine

CPT Codes
When providing psychiatric services by telemedicine, psychiatrists should use the same CPT codes used for an in-person encounter (e.g., 99212+90836 for a combination psychotherapy service, 99215 for a standalone E/M service or 90845 for psychoanalysis).

For all services being provided via telemedicine, use Place of Service (POS) Code 02. Please note that use of POS 02 is required for services provided to Medicare beneficiaries. Please note that some commercial carriers also require the use of modifier 95 to indicate the use of telemedicine. Modifier GT is no longer in use and was retired effective 1/1/18.  

Telehealth Information From Commercial Carriers

To assist members in navigating telemedicine rules and changes to existing requirements, we have compiled the below links to the websites of commercial insurance carriers that have issued updated information regarding the COVID-19 emergency.  Please reach out to individuals carriers if you have any questions or concerns regarding individual policies.   If you encounter any problems, please let NYPSA know.  We will be adding links for information posted by additional carriers if and when it becomes available: 

Prescribing of Controlled Substances
When Patient Has Not Been Seen in Person

As of March 16, 2020, and continuing for as long as the Secretary’s designation of a public health emergency remains in effect, DEA-registered practitioners in all areas of the United States may issue prescriptions for all schedule II-V controlled substances to patients for whom they have not conducted an in-person medical evaluation, provided all of the following conditions are met:

• The prescription is issued for a legitimate medical purpose by a practitioner acting in the usual course of his/her professional practice;
• The telemedicine communication is conducted using an audio-visual, real-time, two-way interactive communication system; and
• The practitioner is acting in accordance with applicable Federal and State laws.

Additional information can be found on the DEA website at https://www.deadiversion.usdoj.gov/coronavirus.html