Potential Changes to Telehealth Visits

Donna White

Donna White

By Donna White, Principal Consultant and Owner of Legacy Consulting Services and Legacy Billing Solutions in Montgomery, Alabama.

The global COVID-19 pandemic has brought an emerging healthcare technology to every-day practice nearly overnight. Two years ago, telehealth was something new that many practices were shying away from. Once the pandemic took over, they became a literal virtual necessity.

Before the pandemic, legislation required many telehealth visits to still occur in a medical facility for their virtual appointment through sophisticated HIPPA-compliant platforms. Regulations loosened once the pandemic hit and now patients are able to use Zoom, Skype or some other platform to meet with providers from their living room couch.

Medicare and Commercial payors were quick to realize that many providers could exclusively see patients this way. Where former billing guidelines required a 02 Place of Service Code, a regular 11 Office Place of Service code was allowed. This meant providers would be reimbursed at their normal Evaluation and Management rates, rather than the reduced Telehealth visit.

Since then, it has been a waiting game for many providers. Commercial payors keep setting then extending the deadlines for when they will revise their pandemic exceptions. As COVID cases finally start to decline in the U.S., the healthcare communally holds their breath as the winter months come, hoping to avoid another spike in cases that were seen during the winter months last year.

There is no way, then, for providers to know when what has become a new business model, will suddenly go back to pre-pandemic times. Some providers have started to charge for Telehealth services, regardless of insurance coverage.

We are seeing this business model pop up across the internet nationwide. Virtual practices can cover basic visits for regular illnesses like colds or UTI’s. They are even able to submit prescriptions for you. You just pay a flat fee per visit. Other specialties, like psychology, are offering virtual counseling sessions and medication management visits for a monthly or yearly rate.

Both lawmakers and commercial payors will need to realize that there is most likely no going back for patients who have become used to telehealth. As people start going back to work and have childcare issues, transportation problems or other barriers to health, they will continue to demand the ease of telehealth visits. Lawmakers and payors will need to catch up.

Source: https://www.inquirer.com/health/consumer/coronavirus-covid-19-telehealth-virtual-visits-insurance-coverage-20210929.html

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