As I write this article, the world is changing every minute. What was being considered standard a few days ago, is not so standard anymore. The way health care professionals learn to practice for decades all around the world is not the norm anymore. And this change brings many questions and many opportunities!!
By now, you know I am referring to COVID-19 pandemic. Leadership all around the world is being challenged to serve their people and try to keep their countries/ communities safe!! The spread is different, the way the population is being affected is different and so does the approach!!
As someone said, “changes are messy in the middle and amazing at the end”. As our world changes by every minute (literally), I want to keep my fellow therapists up to date with some information that just came out last week.
I am not going to discuss all the changes that are happening around, but I do want to talk about the therapy E-Visit in this article.
This information is up to date at the time of the article publish date.
What is the Therapy E-Visit?
In its 2020 physician fee schedule final rule, CMS defines E visit as follows:
“Non-face to face patient-initiated digital communications that require a clinical decision that otherwise typically would have been provided in the office.”
So for all Medicare Part – B patients, therapists. (this includes PT, OT, and SLP) can provide E visit and bill for their services.
Some Rules to be Aware of for E-Visit:
As therapists, you can not initiate the E visit.
That means you can not get on a phone call and start calling each of your patients, to provide your services.
E-Visit needs to be initiated by patients :
Yes, that is correct. It is your patients who need to contact you with questions or ask for advice. However, since this is a new service that therapists are able to provide, You can contact your patients to let them know about this option that is available to them.
How you can connect with the Patients:
CMS says it is better to use a secure (HIPAA compliant) platform. So if you already have a patient portal for your clinic, great! You can use that. The challenges that current time brings, CMS agrees to allow the therapist to use non-HIPAA compliant platforms like phone, text, etc.
You Don’t Need a Video to perform E-Visit:
Yes, that is correct and important to know. E visit is just answering any questions that patients may have. Maybe they want to know how to do certain exercises, how to progress with HEP when your clinics are closed etc.. You can guide them via email, phone or text. APTA is actually recommending people not to use video for E-Visits.
Now, many therapists confuse this with Telehealth. You do need a video to perform telehealth. Telehealth is something, you are assessing and treating the patient, so obviously you are going to need a video.
You do need to document your E-Visit.
The best practice is just to write a note under the current case that you have for the existing patient.
Billing codes for E-Visit:
CMS recommends therapists to use HCPCS codes G2061 to G2063.
Currently, CMS recommends us to use DR condition code (Disaster Related code). This is to ensure that we are performing an E visit as we can not see our clients face to face in this emergency situation.
Therapy E-Visit is only for your existing client:
Yes, the main thing you need to remember that you can only do E-Visits for your existing clientele. This is not for new patients to assess them and treat them.
This visit can only be performed after 7 days of face to face visit:
So CMS says, your patient has a question and would be seeing you for their ongoing treatment weekly. But due to the condition we are in, they are unable to see you face to face in the clinic or homes. So they can contact you and you provide your professional advice. And if this occurs after 7 days of you seeing the patient, you can call it an E-Visit and bill for it.
This does not mean, you as a therapist, can not answer any question your patients might have a day after your face to face visit. It means you can not bill that visit as an E-Visit.
You do not require a Kx modifier or an 1135 waiver to bill for an e-visit.
APTA is working hard to keep us all updated with the changes and guide us in this difficult situation. CMS is the main source where most of the information I provided here is coming from. Here are the main resources that I found very helpful to keep me up to date.