Culver City, CA, Nov. 21, 2018 (GLOBE NEWSWIRE) -- eWellness Healthcare Corporation – (OTCQB: EWLL) – a provider of the state of the art PHZIO platform for the physical therapy (“PT”) and telehealth markets, announced today that the Centers for Medicare and Medicaid have added new CPT codes to reimburse qualified providers who use technology to communicate with and provide care patient care.
According to Mr. Scott Berghoff, https://blog.evisit.com/cms-code-changes-2019?utm_campaign=1%20-%20Mktg%20-%20Blog%20Subscribers&utm_source=hs_email&utm_medium=email&utm_content=67670579&_hsenc=p2ANqtz-_BFNdtm5CN_bjyVB9obXTEX-EkslrdzgtNGXHUOBRA7HJZ7KPHOmgDDmrim2LRxc_m00geLNKOZlG0bJOPoS22ul0KBw&_hsmi=67670579, one of the main barriers reported by Healthcare Professionals (“HCP’s”) for not embracing the powerful tool of telehealth has been the lack of reimbursement. November 1, 2018 the Centers for Medicare and Medicaid (CMS) made a significant step in overcoming this obstacle. It announced its finalization of “Revisions to Payment Policies under the Medicare Physician Fee Schedule, Quality Payment Program and Other Revisions to Part B for CY 2019”
January 1, 2019 will be the beginning of an exciting and more profitable year for HCP’s who utilize telehealth services to provide diverse quality health care for patients. Here is a synopsis of what can be expected.
Two new HCPCS codes, G2010 and G2012, have been created for the calendar year 2019 to pay providers who use communication technology to evaluate and manage patient care. Three new CPT codes, 99453, 99454, and 99457 have been created to address the need to reimburse providers who utilize remote monitoring tools with their patients. Here is a closer look at these new additions to the HCPCS coding.
HCPCS G2012 provides reimbursement for what is called “brief communication technology-based services”. The best example is the virtual check-in. This is not the same as checking in for a scheduled appointment. The virtual check-in allows the provider to evaluate a patient’s condition via electronic communication methods to determine if an office visit is necessary. This offers a great opportunity for patients who may not otherwise pursue treatment for complaints because they would have to drive to the provider’s office. Offering this service for patients is an incredible feature that not only benefits them, but a HCP’s practice as well. Think of it as a potential scheduling-triage, or a way to offer more mobile or remote patients the peace of mind that you’re available if they have a concern, but they aren’t sure whether or not they should come in or make an appointment. Here are some key points to know about this code:
·Patients are responsible for their co-pays.
·Patients must have given verbal consent at each check-in visit.
·This code is limited to established patients only. Only physicians and qualified health care professionals, as defined by the AMA, are eligible to use this code. Depending on the scope of the patient complaint, this means not only physicians, but Nurse Practitioners, Physician Assistants, Clinical Social Workers and Physical therapists, are eligible to bill with this code as well.
·There are no limits on how many times this code can be used with a patient, which makes it ideal for behavioral health care providers, and patients who will benefit from virtual check-ins. There are time limits, if the virtual check-in stems from an emergency room visit that was provided within 7 days, then the check-in is bundled with the original visit. Next, if the virtual check-in determines the patient needs to be seen at the office within 24 hours, or the "soonest available appointment," the virtual check-in is not considered a separate billable event. HCPCS G2010 allows for reimbursement to providers for “Remote evaluation of recorded video and/or images submitted by an established patient…”
·There must be an image (still or video created and sent by the patient, via a HIPAA compliant patient portal or platform like PHZIO.COM).
·G2010 is different from G2012, as the provider must evaluate the image sent by the patient, and then respond to the patient with their findings. Most other requirements are the same, regarding frequency, time limitations, patient copay, and patient location restrictions.
The new CPT codes are reported by the AMA as:
·99453 Remote monitoring of physiologic parameter(s), (for example, weight, blood pressure, pulse oximetry, respiratory flow rate) initial; setup and patient education on equipment use.
·99454: Device(s) supply with daily recording(s) or programmed alert(s) transmission, each 30 days.
·99457: Remote monitoring treatment management services, 20 minutes or more of clinical staff-physician or other qualified health care professional time in a calendar month requiring interactive communication with the patient-caregiver during the month.
These changes show that providers and their staffs, along with patients, are gravitating more toward new technologies. CMS has realized they need to reinforce this shift in the paradigm.
Not only has this change been seen in the monitoring and treatment of patients directly, but interprofessional consults have been addressed too. In today’s busy world, it is often unrealistic for a provider to find the time to sit down at their desk, flipping through a file with one hand while holding the phone to their ear with the other.
These new codes are an excellent step forward that will remove an obstacle from HCP’s who want to implement telehealth protocols into their practices. That acceptance has the potential to lead to increased utilization of telehealth platforms which, as happens with most accepted technologies, will lead to improvements and better iterations.
In 2013, the American Medical Association (AMA) established a definition for a qualified healthcare professional (QHP), in terms of which providers may report medical services:
“A physician or other qualified health care professional’ is an individual who is qualified by education, training, licensure/regulation (when applicable) and facility privileging (when applicable) who performs a professional service within his/her scope of practice and independently reports that professional service.”
QHP’s are distinct from clinical staff. The clinical staff is comprised of employees (leased or contracted staff) who work under the supervision of a physician or other QHP to perform, or assist in the performance of, a specified professional service as allowed by law, regulation, and facility policy; but who do not individually report that professional service (payer-specific policies may also affect who may report specific services). Clinical staff includes medical assistants, licensed practical nurses, registered nurses, and the like.
QHP’s — depending on state scope of practice, licensing, and the Centers for Medicare & Medicaid Services’ (CMS), or other payers’, guidelines — are:
- Nurse practitioner (NP)
- Certified nurse specialist (CNS)
- Physician assistant (PA)
- Certified nurse mid-wife (CNM)
- Certified registered nurse anesthetist (CRNA)
- Clinical social worker (CSW)
- Physical therapist (PT)
Darwin Fogt, CEO stated, “These new CPT codes for Telehealth medical services is a potential gamechanger for the treatment of patients with our PHZIO treatment platform as it may open the door for acceptance of physical therapists as providers of Telehealth services. With new CPT codes established for delivery of medical care via Telehealth, it is clear that a major shift toward incorporating technology into traditional care models is happening. We fully expect CMS to include physical therapy to be an accepted service delivered through Telehealth means”.
About eWellness
eWellness Healthcare Corporation (OTCQB: EWLL) is the first physical therapy telehealth company to offer insurance reimbursable real-time distance monitored treatments. Our business model is to license our PHZIO (“PHZIO”) platform to any physical therapy (“PT”) clinic in the U.S. and or have large-scale employers use our PHZIO platform as a fully PT monitored corporate wellness program. The Company’s PHZIO home physical therapy exercise platform has been designed to disrupt the $30 billion physical therapy and the $8 billion corporate wellness industries. PHZIO re-defines the way physical therapy can be delivered. PHZIO is the first real-time remote monitored 1-to-many physical therapy platform for home use. Due to the real-time patient monitoring feature, the PHZIO platform is insurance reimbursable.
For more information on eWellness go to:
http://www.ewellnesshealth.com/
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For additional information on eWellness Healthcare Corporation and its PHZIO telemedicine products please contact Mr. Darwin Fogt, CEO: 1-855-470-1700.