Impact of 2022 Physician Fee Schedule on Telehealth
With the new Physician Fee Schedule, there will be a lot of changes coming up in 2022. In this blog, I included a variety of different information so that you are aware of some of the upcoming changes. These are some of the notable changes for 2022.
POS Code 10
Introduction of the new place of service (POS) code 10. This will influence future telehealth billing, to learn some of the differences between this new code to POS code 02 please refer to this article below:
CMS Introduces Changes to POS Codes That Will Affect Telehealth Billing - Frost Brown Todd | Full-Service Law Firm
Removing Geographic Restrictions and Audio-Only Reimbursement-Mental Health
Restrictions for tele-behavioral health have been removed for telehealth services for mental health. Please note the new provisions for FQHCs and RHCs as well. For more information please refer to the article below:
CY-2022-Physician-Fee-Schedule-FINAL.pdf (cchpca.org)
Medical Nutrition Therapy
Medical Nutrition Therapy has been added to the services list and recognized that registered dietitians and nutrition professionals can furnish and bill for these services as distant site practitioners.
Registered Dietitians and nutrition professionals have been added to the list of distant site practitioners.
Medical nutrition therapy Group MNT code 97804 to medicare telehealth services list (75 FR 73314 through 73315).
Dietitians and nutrition professionals can also do diabetes self-management training as well.
More details are located starting on page 199 of the PDF of the physician fee schedule.
2021-23972.pdf (govinfo.gov)
Slight Increase to Originating Site Fee Q3014
Reimbursement for the code increased by fifty-seven cents from 2021.
You can find this on page 69 (PDF link below) of the new PFS. On page 70 (Table 18) it lays out how telehealth originating site fees have increased since 2003 based on Medicare’s Economic Index.
2021-23972.pdf (govinfo.gov)
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CMS Releases Article on CY2022 Telehealth Update to the Medicare Physician Fee Schedule
In Mid-January, the Centers for Medicare and Medicaid Services (CMS) sent out an article to providers regarding telehealth billing changes in the Medicare Physician Fee Schedule (PFS), including two new modifiers and a Telehealth Services List update. The update mostly covers recent expansions to mental health treatment via telehealth. For instance, telehealth mental health services are no longer limited to patients in rural areas, can be provided to a patient at home, and in certain circumstances can be provided via audio-only if certain conditions are met. However, these new policies such as the requirement for an in-person visit 6-months prior to the telehealth-delivered services related to mental health will only become active at the end of the federal public health emergency (PHE). Until then, the PHE waivers on telehealth in Medicare are still in place. The letter clarifies the timing for these requirements including when the 6-month prior in-person visit will need to be met. Limited exceptions to the in-person requirements are described, including travel hardships or provider unavailability.
The update also includes 2 new modifiers for telehealth mental health services:
- FQ - A telehealth service was furnished using real-time audio-only communication technology
- FR - A supervising practitioner was present through a real-time two-way, audio/video communication technology
Additional information is included regarding updates to the Medicare Telehealth Originating Site Facility Fee and the addition of new Cardiac Rehabilitation (CR) codes 93797 and 93798 as Category 3 codes on the Telehealth Services List and available through December 31, 2023. Review the full article for additional details.
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