Monday, June 1, 2020

SNF Therapy Telehealth Waivers and other Updated COVID-19 Billing FAQ Updates

The Centers for Medicare and Medicaid Services (CMS) provided important updates to coverage and billing guidance impacting SNF related to COVID-19 1135 waivers. The date, each FAQ was posted or updated is listed immediately under each answer.

New FAQs that SNF providers should review are listed in the following sections:

  • Section L. Medicare Telehealth starting on page 42 which contains several clarifications mostly related to physician services;
  • Section DD. Diagnosis Coding under International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) on pages 69-70 indicate where the current resources are available; and 
  • Section FF. Outpatient Therapy Services on pages 70-71 finally clarifies that telehealth technology can be used to furnish PT, OT, and SLP services for both Medicare Part A and Part B services for facility-based providers including SNF. Specifically, it provides guidance that to identify that a Part B therapy telehealth service under the 1135 waiver was furnished for the SNF outpatient revenue centers 22X or 23X on the UB-04 (CMS-1450) claim, providers must also append a -95 modifier to the claim lines for such services. CMS also affirms that while telehealth technology can be used to furnish therapy services under Part A, such services are not separately payable due to SNF PPS consolidated billing requirements. 

AHCA/NCAL has developed therapy telehealth waivers FAQs that address questions that SNF and AL members may have regarding applying these waivers to improve resident mobility care needs. See Q.10. for Assisted Living resident-specific guidance related to who can provide therapy telehealth in their residence.

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