Telemedicine Rules Relaxed for Pandemic – Review of Ophthalmology

Date: May 7, 2020

Since the pandemic has been declared a national emergency, billing for remote exams is now a lot easier.

This article addresses the following questions:

  • What rules did Medicare relax?
  • How long will the rules remain relaxed?
  • What does the licensure waiver mean?
  • What about providers who had “opted out” of the Medicare system and want to help care for patients during the emergency?
  • What about the relaxing of some of the Stark Law provisions? How does that affect me?
  • What does the “1135 Waiver” mean with regards to HIPAA?
  • How can I protect myself, my staff and patients yet deliver care for them appropriately?
  • If I determine that a patient needs care but it may not be safe to bring them into the office, how do I deliver care remotely?
  • What billing codes apply to phone calls with patients made by doctors?
  • What code applies if the doctor gets a digital image from a Medicare patient who asks for advice during this emergency?
  • We have a secure patient portal. What if the doctors or QHP email back-and-forth with the patient? Is that billable during the COVID-19 emergency?
  • I am a doctor and another doctor called me. She had an immunocompromised patient in the office with an eye condition. Rather than send the patient to me physically, she and I spoke with the patient present at her office. The other doctor felt we could minimize the exposure for the patient that way. After the discussion, I recommended some eye drops for the patient and didn’t need to see the patient physically. Can I get paid for that?
  • What if a patient can avoid coming in physically but I need to use both audio and video to check on her? Can I bill for that?

Published in: Review of Ophthalmology’s Medicare Q & A column

Written by: Senior Consultant, Paul M. Larson, MBA, MMSc, COMT, COE, CPC, CPMA

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