These apply to injured workers receiving medical care via telemedicine for an accepted work related injury. In this blog, we are going to discuss telemedicine guidelines. In particular, we’ll discuss three bullet points most closely related to billing and revenue cycle management.
Understanding New Telemedicine Guidelines for OWCP-FECA
In October of 2020, the new guidelines were released with two important goals in mind: to provide the FECA approved telehealth services and establish how telehealth services need to be submitted for reimbursement.
According to the DOL, “While the FECA program has previously allowed telehealth services, in accordance with the discretion granted to DOL and delegated to OWCP, the FECA program is instituting a new policy concerning telehealth services available to employees receiving medical benefits under the FECA.”
Telemedicine Guidelines for Routine Appointments
The robust bulletin includes a number of actions. We encourage you to read the entire bulletin here, but here are three of the primary bullet points we want to mention in relation to billing and revenue cycle management.
Provider types eligible for reimbursement
Four: “Provider types eligible to be reimbursed for telehealth services in the FECA program are limited to: 25 Physician, 32 Psychologist (with Specialty type 42 for psychiatrists), 77 Social Worker, 28 Chiropractor, 72 Occupational Therapist, and 71 Physical Therapist. Eligible provider types may be modified based on future needs of the program.”
Telemedicine guidelines for billing using appropriate modifiers, billing codes, and addresses
Five: “Providers should bill utilizing appropriate modifiers, billing codes, and the claimant’s address as the location of delivery of the medical care if applicable. OWCP recognizes modifiers GT (via interactive audio and video telecommunications systems), GQ (via an asynchronous telecommunications system), and 95 (synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system) as required billing code modifiers for telehealth services. Providers should use the most appropriate place of service (POS) when billing. For telemedicine or home services the following POS should be used: 12 – Patient home (if the claimant is located at home during the visit).”
Information to provide when submitting a bill for payment
Seven: “Along with the bill for services, the provider must provide the following information when the bill is submitted for payment:
- a) Appointment Notes that articulate the method of telemedicine that the provider employed and the length of visit (prolonged services in physical condition cases should be rare);
- b) Any vitals or medical evidence collected;
- c) An outline of the medical need and the benefit derived from the appointment, as it relates to the claimant’s accepted condition(s); and
- d) The additional contents of the notes should comport with the FECA Regulations set forth at 20 C.F.R. § 10.330.”
How Do These Telemedicine Guidelines Apply to Your Practice?
Navigating the many guidelines outlined by the DOL can be trickier than ever. This is especially true with the addition of the new telemedicine guidelines. One of the best ways to ensure your practice meets these guidelines is enlisting professional RCM services for your practice.
RevStream Services is here to help! We will help you streamline your medical billing and collections process while also ensuring you adhere to telemedicine guidelines. Contact us today to get started.