Practices will be able to bill for audio-only telephone evaluation and management (E&M) visits during the same month as chronic care management (CCM) visits throughout the COVID-19 public health emergency, the Centers for Medicare & Medicaid Service (CMS) has announced.
The change is part of several updates to Medicare’s fee-for-service billing policies regarding telehealth and Medicare Part B covered drugs and vaccines – specifically COVID-19 vaccines, CMS said in a frequently asked questions (FAQ) document published March 5.
The FAQ also includes extensive updates on the Medicare Shared Savings Program for Accountable Care Organizations (ACOs).
Throughout the public health emergency, CMS has maintained several COVID-19-related Medicare waivers and flexibilities, including paying the same rate for telemedicine visits as for in-person visits, and allowing use of audio-only telemedicine services.
CMS updated the policy on CCM monthly billing under the expectation “that in most cases the time counted toward CCM would be clinical staff minutes while the time counted for audio-only phone [E&M] services would represent a direct interaction between the patient and the billing professional.”
Practices can use current procedural terminology (CPT) codes 99441-99443 to report audio-only office/outpatient E&M visits, “including during a month where chronic care management services are being furnished, and these codes can therefore be reported in the same time period as CCM services,” CMS said.
For ACOs, Medicare expanded the list of remote primary care services that can be billed throughout the public health emergency to include remote evaluation of patient video or images; virtual check-ins; and digital E&M services, including for audio-only.
Other CMS updates to ACO policies include:
- What an ACO or its participants should do if they do not report the Quality or Promoting Interoperability categories to the Merit-based Incentive Payment System (MIPS);
- How CMS will adjust calculations while the Medicare sequestration is in effect; and
- Whether the Medicare Shared Savings Program extreme and uncontrollable circumstances policy for quality apply to all ACOs for performance year 2021.
CMS also clarified that all health care professionals who are authorized under applicable state scope of
practice and licensure requirements can administer COVID-19 vaccines to Medicare patients. In Texas, that includes licensed nurses, medical assistants, emergency medical services professionals, and certain clinical staff members.
CPT copyright American Medical Association. All rights reserved.