17 Feb Telehealth and remote patient monitoring
Telehealth Reporting and Information in Home Health
Starting on or after January 1, 2023, home health agencies may voluntarily report the use of telecommunications technology in providing Home Health services on claims. Although it is voluntary for now, effective July 1, 2023, this information will be required. This home health care blog will highlight how this impacts agencies providing Medicare services and provide additional facts for those interested in learning more about the changes with CMS.
How does CMS define telehealth and remote patient monitoring?
Telehealth, sometimes referred to as telemedicine, is the use of electronic information and telecommunications technologies to extend care when a caregiver and the patient aren’t in the same place at the same time. Remote patient monitoring is the collection of physiological data (electrocardiogram, blood pressure, glucose monitoring) digitally stored or transmitted by the patient or caregiver to the home health agency.
Is there a change to my cost reporting?
Yes, Telecommunications technology including remote patient monitoring has been added as an allowable administrative cost for cost reporting.
What benefit does it provide to include telehealth information on the claim?
CMS will use this information to:
- Analyze the characteristics of patients using services provided remotely.
- Have a broader understanding of the social determinants that affect who benefits most from these services, including what barriers may potentially exist for a certain subset of patients.
What is required on the Plan of Care to provide telehealth services?
Your plan of care must describe how the technology is tied to the patient-specific needs in the comprehensive assessment. These services do not substitute for a home health visit as ordered on the plan of care and cannot be considered a home visit for the purposes of patient eligibility or payment.
Who can provide telehealth services?
CMS allows agencies to bill the telehealth services provided by: Skilled Nursing, Home Health Aides, Physical Therapists, Occupational Therapists, Speech Therapists, and MSW.
How is this documented in the medical records?
You must document the medical record to show how the telecommunications technology helps to achieve the goals outlined in the plan of care.
What do I need to know to include these services on the claim?
Your agency will need to add billing codes to identify telehealth provisions. Since there are 3 G-Codes that can be administered by up to 6 disciplines, you could essentially create up to 18 billing codes for each discipline. You need to make sure you select the appropriate revenue code to identify the discipline providing the telehealth. The three G-Codes are:
- G0320: Home health services furnished using synchronous telemedicine rendered via real-time two-way audio and video telecommunications system
- G0321: Home health services furnished using synchronous telemedicine rendered via telephone or other real-time interactive audio-only telecommunications system
- G0322: The collection of physiologic data digitally stored and/or transmitted by the patient to the home health agency (for example, remote patient monitoring)
Some example billing code names could be: SN Telehealth Audio and Video, SN Telehealth Audio only, SN Telemonitoring, PT Telehealth Audio Only, etc.
Telehealth codes must be billed as daily units (1 unit = 1 day).
*Do not use telehealth billing codes for disciplines that do not have a completed home health visit on the scheduler as these claims will be returned to the provider for correction.
Click on the links below to learn more about telehealth and the CMS changes for telehealth coverage:
Telehealth Best Practices: https://www.youtube.com/watch?v=kdTc2Wbi_Ag
CMS Medicare Claims Processing: https://www.cms.gov/files/document/r11502CP.pdf
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