With the end of the COVID-19 public health emergency fading into history, many suppliers still have questions about the reliability of telehealth visits. The two we get most frequently are:
  1. Do DME suppliers need to denote the reliance on telehealth when submitting claims?
  2. Can suppliers rely on telehealth visits conducted via audio only (no video)?

Next Episode: Thursday, February 22, 2024

Do DME suppliers need to denote the reliance on telehealth when submitting claims? Noridian Healthcare Solutions, the DME MAC for Jurisdictions A and D, answered this question directly in its June 2023 Collaborative Post PHE FAQ. In answering question six, Noridian wrote:
“DMEPOS suppliers are not required to append any modifiers on the claim or add a claim narrative to indicate a Medicare approved telehealth visit was performed. This information should be documented in the beneficiary’s medical record.”
Suppliers need not differentiate between in-person and telehealth visits for billing or audit purposes. Can suppliers rely on telehealth visits conducted via audio only (no video)? Based on my research of the existing guidance, telehealth visits should include audio and video components. The doctor is making a medical diagnosis and treatment recommendations, and Medicare’s default position is that eyes and ears are better than listening alone. Having said that, there are certain telehealth visits billable to Medicare in the absence of a video component. Most of the CPT codes that Medicare approves for audio-only telehealth visits are for mental health, but some apply to general office visits. CMS’s list of approved telehealth services denotes which services qualify for audio-only visits. Suppliers can download the complete list at https://www.cms.gov/files/zip/list-telehealth-services-calendar-year-2023.zip. Noridian recommends suppliers confirm with the treating physician that any telehealth visits supporting the provision of DME services are Medicare approved … and that is good advice.