Follow up visits after telemed checkups

What are people planning to do about follow up appointments after doing a telemed checkup? When? How to code?

I think it will likely vary across payers and also what states we are in. I am surprised how many of our patients are coming in when we recall them. Fewer than expected are taking us up on the TM option. We are moving from two months of shelter in place to β€œPhase 3” in IL in 2 days.

In Massachusetts our medicaid plan MassHealth came out 2 weeks ago with guidance on how to bill and code the follow up portion of virtual well visits. They arfe letting us code a 99211, 12 or 13 with the procedure codes at the catch up visit.

It is in the MassHealth All Provider Bulletin 294 May 2020
Page 8-9

The full link is here: https://www.mass.gov/doc/all-provider-bulletin-294-masshealth-coverage-flexibilities-for-services-related-to-coronavirus/download

Important excerpt here:

"β€’ For a preventive visit conducted via telehealth, providers may bill:
-An appropriate preventive visit code plus β€œ02” for place of service;
**-Any additional codes applicable to the service provided (e.g., developmental screening,health risk assessment, behavioral/emotional assessment); and **
-Separately for vaccines administered on the same date as the telehealth visit, as the vaccine administration and the telehealth visit do not occur in the same location. **
** Providers may not use place of service code β€œ02” when submitting claims for such same-day vaccine administrations.

β€’ For an in-person follow-up visit to complete medically necessary components of the preventive visit, not performed on the same day as the preventive visit, providers may bill:
-A single E&M visit at level 1, 2, or 3 (appropriate to complexity of visit); and any additional codes applicable to the service provided (e.g., laboratory, hearing/vision screening).

Providers must document all required components of all visits, including preventive visits. Documentation of preventive visits conducted via telehealth must indicate that the visit was completed via telehealth due to the COVID-19 emergency, note any limitations of the visit, and include a plan to follow up any medically necessary components deferred due to those limitations.

MassHealth will apply this policy to all dates of service beginning on March 12, 2020."

3 Likes

We’re still in phase 1 getting ready for 2 in our county in Maryland. I am VERY concerned about the quoted 6/18 deadline from BC/BS. We are starting to alert our patients and will have to have online waivers for all telemeds sooner versus later.