The announcement late last month that Medicare will pay for audio-only telehealth visits at the same rate as similar in-person visits was a welcome change for physicians in light of the rapid growth of telemedicine.
The fact that it would be retroactive to March 1 was even better news considering the number of practices struggling with decreased revenue and reduced in-person patient visits.
But one question has remained unanswered: whether Medicare Administrative Contractors (MACs) will automatically reprocess those already-submitted claims, or if physicians will need to resubmit them.
To date, the Centers for Medicare & Medicaid Services (CMS) has not published a clear answer to that question.
This has been a source of frustration for physicians, who already are overly burdened by administrative and regulatory requirements. That burden has been particularly acute during the COVID-19 pandemic.
The American Medical Association (AMA) addressed the question in an email to members today.
“CMS has informed us that the MACs will be expected to automatically adjust retroactive changes to claims payment. That being said, CMS also noted that it can take time to implement changes,” the email said. “During COVID-19, the agency did not have the usual time between publishing a new (interim) final rule and pushing out and implementing the usual change requests that happen in the normal course of events. CMS recommends that physicians give the MACs some time to catch up and then check with the MACs if they have questions.”
In an email to the Texas Medical Association last week, a CMS official said physicians or other health care professionals “can contact the MAC for guidance on correcting a claim.”
In a webinar last week, Novitas Solutions –Texas’ MAC – provided four options for physicians who want to submit claims corrections:
TMA will continue to reach out to CMS and Novitas for information on who will be responsible for filing corrected claims, and what steps physicians should take – if any.
Meanwhile, if you would like more help understanding how to utilize telemedicine, listen to TMA’s webinar, Telemedicine During COVID-19, and take a close look at TMA’s Practice Viability Toolkit, which includes sections on telemedicine and human resources.
Remember, you can find the latest news, resources, and government guidance on the coronavirus outbreak by visiting TMA’s COVID-19 Resource Center, which includes a section on telemedicine.
If you would like to speak with TMA directly about your telemedicine billing questions, the Hassle Factor Log team can help you. We also can help you with any other questions about billing and coding or payer policies.
Email the specialists for help, or call the TMA Knowledge Center at (800) 880-7955.