Tag Archives: virtual healthcare

CMS expands Telehealth Services to Deliver Care Safely during COVID-19 and Beyond

During the COVID-19 pandemic, CMS has taken the necessary steps to make it easier to provide quality care through telehealth services. This unprecedented action by CMS has encouraged healthcare providers to adopt and use telehealth as a way to safely provide care to their patients in situations like medication consultation, eye exams, nutrition counseling, behavioral health counseling, and routine health check-ups like annual wellness visits. Past data have shown telehealth to be an effective medium for patients to access healthcare providers especially for managing chronic conditions like diabetes, asthma or to obtain mental health counseling.

Advantages of CMS changes to Telehealth:

Telehealth services made permanent post-COVID-19:

CMS has announced that 60 of the 144 telehealth services that were newly offered during the pandemic will become permanent. This includes services for cognitive assessment, psychological and neuropsychological testing, and custodial care services for established patients.

They have also finalized the decision that direct supervision in telehealth visits can be provided with interactive audio and video technology through the end of the year until December 2021.

CPT Code	Services	Description
77427	Radiation management	It is reported once for every five fractions or treatment sessions regardless of the actual time period in which the services are furnished. The services need not be furnished on consecutive days.
90853	Group psychotherapy	Group psychotherapy including interpersonal interactions and support with several patients; typically 45 to 60 minutes in length.
90953	End-stage renal disease, one visit per month, ages 2 and younger	End-stage renal disease (ESRD) related services monthly, for patients younger than 2 years of age to include monitoring for the adequacy of nutrition, etc.
90959	End-stage renal disease, one visit per month, ages 12-19	End-stage renal disease (ESRD) related services monthly, for patients 12-19 years of age to include monitoring for the adequacy of nutrition, assessment of growth
90962	End-stage renal disease, one visit per month, ages 20 and older	With 1 face-to-face physician visit per month
92057	Speech/hearing therapy	Treatment of speech, language, voice, communication, and/or auditory processing disorder, individual
92521	Evaluation of speech fluency	Evaluation of speech fluency (e.g., stuttering, cluttering)
92522	Evaluation speech production	Evaluation of speech sound production (e.g., articulation, phonological process, apraxia, dysarthria)
92523	Speech sound language comprehension	Evaluation of speech sound production (e.g., articulation, phonological process, apraxia, dysarthria)
92524	Behavioral quality voice analysis	Behavioral and qualitative analysis of voice and resonance.
96130	Psychological test Evaluation Phys/qhp 1st	Psychological testing evaluation services by a physician or other qualified healthcare professional, including the integration of patient data, interpretation of standardized test results and clinical data
96131	Psychological test evaluation phys/qhp ea	Providers should now use CPT code 96130 to bill for the first hour of psychological testing evaluation services and 96131 for each additional hour
96132	Neuropsychological testing evaluation phys/qhp 1st	Neuropsychological testing evaluation services by physician or other qualified healthcare professional, including integration of patient data, interpretation of standardized test results and clinical data, clinical decision making, treatment planning and report, and interactive feedback to the patient, family member(s) or caregiver(s), when performed; first hour
96133	Neuropsychological testing evaluation phys/qhp ea	The first hour of neuropsychological evaluation is billed using 96132 and each additional hour needed to complete the service is billed with code 96133
96136	Psychological and neurological testing phy/qhp 1s	Psychological or neuropsychological test administration/scoring by physician or other qualified healthcare professional, two or more tests, any method; first 30 minutes
96137	Psychological and neurological testing phy/qhp ea	Similar to 96136. This code is used for each additional hour.
96138	Psychological and neurological tech phy/qhp ea	Psychological or neuropsychological test administration/scoring by technician, two or more tests, any method; first 30 minutes
96139	Psychological and neurological testing tech ea	Similar to 96138.
97110	Therapeutic exercises	Foundational, occupational therapy exercises that are designed to improve a patient’s strength, range of motion, endurance, or flexibility.
97112	Neuromuscular re-education	Specific exercises or activities performed and for what purpose, neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, and/or posture.
97116	Gait training therapy	Therapeutic procedure, one or more areas, each 15 minutes; gait training (includes stair climbing).
97161	Physical therapy evaluation	Physical therapy evaluation of low complexity, 20 min
97162	Physical therapy evaluation	Physical therapy evaluation moderate complexity, 30 min
97163	Physical therapy evaluation	Physical therapy evaluation moderate complexity, 30 min
97164	Physical therapy evaluation	Physical therapy re-evaluation establish plan care
97165	Occupational therapy evaluation	Occupational therapy evaluation low complexity, 30 min
97166	Occupational therapy evaluation	Occupational therapy evaluation moderate complexity, 45 min
97167	Occupational therapy evaluation	Occupational therapy evaluation high complexity, 60 min
97168	Occupational therapy	Occupational therapy re-evaluation establish plan care
97535	Self-care management training	Direct one-on-one supervision and instruction regarding activities of daily living related to the patient’s health and hygiene.
97750	Physical performance test	Physical performance test or measurement (e.g., musculoskeletal, functional capacity), with written report, each 15 minutes.
97755	Assistive technology assessment	This procedure is used by the provider to assess the suitability and benefits of technological interfaces that will help restore, augment, or compensate for existing functional ability in the patient.
97760	Orthotic management and training 1st en	Orthotic(s) management and training (including assessment and fitting when not otherwise reported), upper extremity(ies), lower extremity(ies) and/or trunk, initial orthotic(s) encounter, each 15 minutes.
97761	Prosthetic training 1st enc	Prosthetic training, upper and/or lower extremities, initial prosthetic encounter, each 15 minutes
99217	Observation care discharge	This code is used to report all services provided to a patient discharged from outpatient hospital “observation status” if the discharge is on a date other than the initial date of “observation status
99218	Initial observation care	The first visit of the patient’s admission for outpatient hospital observation care by the Admitting/Supervising Physician or Other Qualified Healthcare Professional. Typically, 30 minutes are spent at the bedside and on the patient’s hospital floor or unit.
99219	Initial observation care	Similar to 99218 but, 50 minutes are spent at the bedside and on the patient’s hospital floor or unit.
99220	Initial observation care	Similar to 99218 but, 70 minutes are spent at the bedside and on the patient’s hospital floor or unit.
99221	Initial hospital care	Office or other outpatient visit for the evaluation and management of an established patient that may not require the presence of a physician.
99222	Initial hospital care	Similar to 99221
99223	Initial hospital care	Similar to 99221
99234	Observation/hospital same date	Observation or inpatient care, are used when the patient is placed in observation status or admitted to inpatient status and then discharged on the same date.
99235	Observation/hospital same date	Observation or inpatient care is used when the patient is placed in observation status or admitted to inpatient status and then discharged on the same date.
99236	Observation/hospital same date	Observation or inpatient care is used when the patient is placed in observation status or admitted to inpatient status and then discharged on the same date.
99238	Hospital discharge day	Used when time spent is less than 30 minutes on the discharge process in face-to-face evaluation.
99239	Hospital discharge day	Used when time spent is greater than 30 minutes on the discharge process in face-to-face evaluation.
99281	Emergency department visit	Requires these 3 key components: A problem-focused history; A problem-focused examination; and Straightforward medical decision-making. Usually, the presenting problem(s) are self-limited or minor.
99282	Emergency department visit	Requires these 3 key components: An expanded problem-focused history; An expanded problem-focused examination; and Medical decision-making of low complexity. Usually, the presenting problem(s) are of low to moderate severity.
99283	Emergency department visit	Requires these 3 key components: An expanded problem-focused history; An expanded problem-focused examination; and Medical decision-making of moderate complexity. Usually, the presenting problem(s) are of moderate severity.
99284	Emergency department visit	Requires these 3 key components: A detailed history; A detailed examination; and Medical decision-making of moderate complexity. Usually, the presenting problem(s) are of high severity, and require urgent evaluation by the physician but do not pose an immediate significant threat to life or physiologic function.
99285	Emergency department visit	Usually, the presenting problem(s) are of high severity, and require urgent evaluation by the physician but do not pose an immediate significant threat to life or physiologic function.
99291	Critical care first hour	It is used to report the services of a physician providing full attention to a critically ill or critically injured patient from 30-74 minutes on a given date
99292	Critical care additional 30 mins	Code 99292 (critical care, each additional 30 minutes) is used to report additional block(s) of time, of up to 30 minutes each beyond the first 74 minutes of critical care.
99304	Nursing facility care initial	The problem(s) requiring admission are of low severity. Typically, 25 minutes are spent at the bedside and on the patient’s facility floor or unit.
99305	Nursing facility care initial	The problem(s) requiring admission are of moderate severity. Typically, 35 minutes are spent at the bedside and on the patient’s facility floor or unit.
99306	Nursing facility care initial	The problem(s) requiring admission are of high severity. Typically, 45 minutes are spent at the bedside and on the patient’s facility floor or unit.
99315	Nursing facility discharge day	99315 is for discharge day management 30 minutes or less
99316	Nursing facility discharge day	This code is for discharge day management over 30 minutes
99327	Domiciliary or rest home visit new patient	Domiciliary or rest home visit for the evaluation and management of a new patient. Usually, the presenting problem(s) are of high severity. Typically, 60 minutes are spent face-to-face with the patient and/or family.
99328	Domiciliary or rest home visit new patient	Code used for Evaluation and Management / Domiciliary, rest home (boarding home) or custodial care services. The general guidance for this code is that it is used for new patient assisted living visits, typically 75 minutes.
99334	Domiciliary or rest home visit established patient	This code 99334 is used to reflect the domiciliary or rest home visit for the E/M of an established patient
99335	Domiciliary or rest home visit established patient	Similar to 99334
99336	Domiciliary or rest home visit established patient	Similar to 99334
99337	Domiciliary or rest home visit established patient	Domiciliary or rest home visit for the evaluation and management of an established patient. Usually, the presenting problem(s) are moderate to high severity. Typically, 60 minutes are spent face-to-face with the patient and/or family
99341	Home visit new patient	Home services are provided in a private residence. A home visit cannot be billed by a physician unless the physician was actually present in the beneficiary’s home. Level 1 new patient home visit.
99342	Home visit new patient	Home services are provided in a private residence. A home visit cannot be billed by a physician unless the physician was actually present in the beneficiary’s home. Level 2 new patient home visit.
99343	Home visit new patient	Home services are provided in a private residence. A home visit cannot be billed by a physician unless the physician was actually present in the beneficiary’s home. Level 3 new patient home visit.
99344	Home visit new patient	Home services are provided in a private residence. A home visit cannot be billed by a physician unless the physician was actually present in the beneficiary’s home. Level 4 new patient home visit.
99345	Home visit new patient	Home services are provided in a private residence. A home visit cannot be billed by a physician unless the physician was actually present in the beneficiary’s home.Level 5 new patient home visit.
99347	Home visit established patient	Home visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components. A problem-focused interval history; a problem-focused examination; and straightforward medical decision making. Typically, 15 minutes are spent face-to-face with the patient and/or family.
99348	Home visit established patient	Similar to CPT Code 99348. Typically, 25 minutes are spent face-to-face with the patient and/or family.
99349	Home visit established patient	Similar to CPT Code 99348. Typically, 40 minutes are spent face-to-face with the patient and/or family.
99350	Home visit established patient	Similar to CPT Code 99348. Typically, 60 minutes are spent face-to-face with the patient and/or family.
99468	Neonatal critical care initial	Services of directing the inpatient care of a critically ill neonate or infant 28 days or younger.
99469	Neonatal critical care initial	Services of directing the inpatient care of a critically ill neonate or infant 28 days or younger.
99471	Pediatric critical care initial	Initial inpatient pediatric critical care, per day, for the evaluation and management of a critically ill infant or young child, 29 days through 24 months of age
99472	Pediatric critical care initial	Subsequent inpatient pediatric critical care, per day, for the evaluation and management of a critically ill infant or young child, 29 days through 24 months of age
99473	Self-measurement of blood pressure at home education/training	Code 99473 represents the work of training the patient and calibrating the device,
99475	Pediatric critical care ages 2-5 initial	Initial inpatient pediatric critical care, per day, for the evaluation and management of a critically ill infant or young child, 2 through 5 years of age
99476	Pediatric critical care ages 2-5 subsequent	Subsequent inpatient pediatric critical care, per day, for the evaluation and management of a critically ill infant or young child, 2 through 5 years of age
99477	Initial day of hospital care for neonatal care	Initial hospital care of the neonate (28 days or younger) who is not critically ill but requires intensive observation, frequent interventions, and other intensive care services.
99478	Ic low-birthweight infant	Intensive care, per day, for the evaluation and management of the recovering low or very low birth weight infant( < 1500 gm)
99479	Ic low-birthweight infant < 1500-2500 g subsequent	Intensive care, per day, for the evaluation and management of the recovering low or very low birth weight infant( 1500 gm-2500g)
99480	Ic infant pbw 2501-5000 g subsequent	Intensive care, per day, for the evaluation and management of the recovering low or very low birth weight infant(2501g-5000g)
99483	Assessment and care plan cognitive impairment	Assessment of and care planning for a patient with cognitive impairment, requiring an independent historian, in the office or other outpatient, home or domiciliary or rest home

The ongoing pandemic has resulted in an increased workload for healthcare providers across the country. Incorporating telehealth software into an existing practice can allow providers to virtually connect with patients. This can relieve the strain on practice while introducing an additional revenue stream.

HealthViewX Telehealth/Telemedicine Platform helps health systems to align clinical, financial, and operational goals by providing high-quality remote care and enhancing patient-physician collaborations.

References: https://www.beckershospitalreview.com/telehealth/cms-adds-85-more-medicare-services-covered-under-telehealth.html

How COVID-19 is changing the Healthcare Industry

The COVID-19 Pandemic has greatly challenged the existing capabilities of the Healthcare Industry. The rapid spread of the virus has brought the world to a standstill and has health leaders scrambling to find new approaches to healthcare. Despite the obstacles that have been thrust upon the industry, the prospect of technological advancement gives the healthcare industry an opportunity for accelerated growth.

Short-Term Impact of COVID-19

One of the main consequences of the Pandemic has been undermanned or under-equipped health staff. The intensity of the virus has left many clinics with less than the required resources to help COVID patients. Another related issue faced mainly by urban health clinics is Hospital Overcrowding. Non-COVID related patients will also see delays in their care journeys. The healthcare industry must also prepare for the following long-term impacts of the COVID-19 Pandemic.

Increasing Role of Virtual Health services

The pandemic has revealed the importance of virtual health care services such as Telehealth and Remote Physiological Monitoring (RPM). The contagious nature of COVID-19 has forced many clinics to close their doors to non-COVID patients. Without virtual care technology, many patients with chronic or other severe conditions would lose access to essential healthcare. In addition, clinics would be losing a significant portion of their revenue. However, providers who utilize a virtual telemedicine platform are still able to connect with their patients. As of 2017, some form of Telemedicine platform is employed by over three-quarters of hospitals in the US. The pandemic will cause that number to increase while encouraging existing users of telehealth to make their platforms more extensive.

Eliminating the Traditional Care Journey

The emergence of telemedicine has allowed for the virtual exchange of high-quality health services. By using virtual technology, physicians are able to provide check-ups, patient education, and care plans. Patients can access these services from the comfort of their homes. This new development due to the pandemic has brought into question the future of traditional clinical visits. Hassle-free telemedicine solutions have exposed the inefficiencies of conventional care journeys. Previously, patients might waste an entire day for a simple check-up due to long wait times and large clinical facilities. In the end, they may not even receive conclusive treatment if they are referred to another practice. These inefficiencies contribute to a high patient no-show rate, which costs the American healthcare industry over $150 billion/year. Convenient telemedicine platforms remind patients ahead of their appointments and provide them with effective and timely care.

Altering the future of Value-Based Care

While the “Value-Based Care” movement has been gaining momentum for a few decades, the COVID-19 pandemic might slow down the shift. The decrease in elective surgeries and non-COVID related care has been financially crippling for many practices. While RPM and Telehealth reimbursement codes cover for some of these losses, clinics are still seeing a decline in revenue due to the pandemic. The deal-breaker for most clinics involves the financial risk involved in a Value-Based model. Many Value-Based contracts involve a great deal of downside risk, or potential financial shortcomings due to missed targets. This financial risk may have over half of Accountable Care Organizations (ACO) consider abandoning this model. This may also encourage current fee-for-service providers to avoid adopting a Value-Based platform in the future. In order to mitigate a large-scale exodus from the Value-Based scheme, the CMS could subsidize providers by removing downside risk clauses for the near future.

Accelerating the Adoption of Artificial Intelligence

Artificial Intelligence (AI) is emerging as a new solution for the current healthcare-related issues. AI involves the use of machines to perform human activities such as learning, interpreting, and analyzing. While AI in healthcare has not yet reached its full potential, investment in this field is expected to grow tenfold between 2014 and 2024. While AI systems are still in an early developmental stage, they are already used by many providers in areas such as diagnosis, patient education, and predictive analysis.

Robotic machines are an example of how AI could be put into action in a healthcare setting in the near future. These systems could carry out tasks like patient engagement, or even remote surgery. When dealing with infectious diseases like COVID-19, AI based robots could eliminate unnecessary human interactions, thus decreasing the risk of transmission. When used for diagnosis and treatment, these machines are significantly more accurate than existing technology. In the long run, AI could lead the way for virtual/augmented reality to make its way into mainstream healthcare.

The COVID-19 pandemic has proven to be a watershed event in the history of medical care. While the industry continues to face immense challenges, greater opportunities for growth lay ahead.

Talk to us to understand how HealthViewX is transforming the Care Journey for both patients and providers!

Implementing Virtual Care in Referral Management to Enhance Patient Experience

Today, healthcare organizations are working diligently to improve care coordination, care continuity, and patient experience. Among these targets, improving patient experience is the primary goal that organizations want to achieve. Organizations are working towards streamlining processes to smoothen the patient care journey and improve the overall patient experience.

How can you deliver the best experience to patients?

Emerging global health challenges such as Aging baby boomers and increased chronic health issues have placed an increased strain on the existing medical and social services. The US healthcare system is the costliest in the world, accounting for 17% of the Gross Domestic Product (GDP) in 2018. This number is expected to grow to nearly 20% by 2020. [Source: National Healthcare Expenditure Projections, 2010-2020. Centers for Medicare and Medicaid Services, Office of the Actuary.]

Addressing all the three dimensions of triple aim at the same time is crucial. A systematic approach to streamline processes will result in a healthier population, and assure a seamless journey through the whole system of care. A comprehensive automation solution can help simplify processes, and enable the entire system to manage change in a structured manner, paving the way for better patient experience.

Today, one of the processes that would be improved with automation is patient referral management. Patient satisfaction or experience, and quality care depend on effective care coordination not just within the physician’s office but also between physician’s primary health centers, and other care settings (specialty centers, hospitals, health systems, etc.). Using a smart platform for prior authorization, specialists match to alert when referrals need attention and automatically send patient updates to referring providers. This provides them with real-time analytics to gain better insights and also closes the referral loop, which addresses the biggest issue in the referral process today.

Ensuring care continuity and coordination of care for patients by easily scheduling the right specialists will transform the health center to meet the patient’s comprehensive health needs. Increased efficiency of the referral process leads to quality care and better patient experience.

The Use of Video Conferencing in Referral Management

Innovative methods are needed to enhance care quality, improve access to care, and improve patient outcomes. Video conferencing is one such feature that enables real-time two-way video with audio transmission and sharing of diagnostic images, and more. It helps patients to access healthcare services without the burden of travel and receive timely care.

Want to know more? Schedule a demo and talk to HealthViewX solution experts to understand in detail about our virtual care capability in the Referral Management Solution.