Important News
CMS is finalizing the addition of a number of codes to the telehealth services list as well as creating a third temporary category of criteria for adding services to the list of Medicare to create another list of temporary codes that could be delivered via telehealth to Medicare beneficiaries during the COVID-19 public health emergency. CMS is also establishing on an interim basis for CY2021 payment for a new HCPCS G-code for a virtual check-in describing 11-20 minutes of medical discussion to determine the necessity of an in-person visit. Despite comments from AUA and other stakeholders, CMS did not make any changes to its telephone E/M policy to allow these visits to be conducted with audio-only connections once the public health emergency concludes; therefore, coverage of audio-only telehealth visits will not be extended beyond the public health emergency.
AUA Resources:
- AUA Letter to CMS Regarding Telehealth Flexibilities [pdf]
- AUA Frequently Asked Questions on Telehealth [pdf]
- AUA Whitepaper: Telemedicine in Urology (includes guidance to help members who are considering providing telehealth services to their patients)
- Insurance Coverage and State Legislation Tracking Spreadsheet [.xlsx]
Webinars and Podcasts
- AUA Webinar: Telehealth A to Z
- Podcast: Getting your Practice Up and Running with Telemedicine with Dr. Eugene Rhee
- Podcast: Coding for Virtual Visits with Dr. Jonathan Rubenstein
- Podcast: COVID-19: Understanding HIPAA Relief Provisions for Telehealth with Alisa Chestler
Additional Resources
Telehealth Implementation
- ACP: Telemedicine: A Practical Guide for Incorporation into your Practice
- AHRQ Sample Telemedicine Consent Form
- AMA: Updated Telehealth Quick Guide
- American Telemedicine Association
- CDC: Using Telehealth to Expand Access to Essential Health Services during the COVID-19 Pandemic
- CMS: Telehealth Toolkit for General Practitioners
- HHS: Telehealth: Delivering Care Safely During COVID-19
- HHS: Telemedicine Hack Web Course [pdf]
Coding and Payment Resources
- AMA Coding Advice and Scenarios
- AMA: Medicare Payment Policies
- CMS: Medicare Coverage and Payment of Virtual Services (Video)
- CMS: Medicare Frequently Asked Questions (FAQs) 5/1/2020 (For telehealth changes, see page 24-35)
- CMS: Medicare Advantage and Part D Sponsor Guidance (Some MA plans have expanded telehealth services; inquiries should be directed to the specific plan.)
- CMS: FAQ for State Medicaid and Children’s Health Insurance Program Agencies (Medicaid eligibility and reimbursement for telehealth vary by state. Check with your state’s Medicaid Administrator regarding rules and regulations.)
Note: Private payor reimbursement for telehealth varies by state. Contact the applicable private insurer to find out what telemedicine services are being reimbursed. The AUA’s tracking spreadsheet at the top of this page provides additional guidance.
Telehealth Regulatory Resources
Medicare Interim Rules and Waivers
- CMS Expansion of Telehealth Benefits Press Release March 17, 2020
- CMS: Medicare Telemedicine Health Care Provider Fact Sheet March 17, 2020
- CMS: Medicare Telehealth Frequently Asked Questions (FAQs) March 17, 2020
- CMS Interim Final Rule Press Release March 30, 2020
- CMS Physicians and Other Clinicians Fact Sheet April 29, 2020
- CMS 2nd Interim Final Rule Press Release April 30, 2020
Other Resources:
- FSMB: U.S. States and Territories Modifying Requirements for Telehealth in Response to COVID-19
- Office of Inspector General (OIG) Statement on Reduced/Waived Cost-Sharing for Telehealth During the COVID-19 Pandemic. (View related FAQs)
- Office of Civil Rights Notification of Enforcement Discretion for HIPAA Waivers for Telehealth Services. (View related FAQs)
- Drug Enforcement Administration (DEA) Guidance for Prescriptions of Schedule II-V Drugs During the COVID-19 Pandemic.