In a Newsline dated October 27, 2020, the California Division of Workers Compensation (DWC) announced the adoption of the updated Medicare List of Telehealth Services, which includes eleven (11) new codes. The DWC’s inclusion of the eleven new telehealth services to the Official Medical Fee Schedule (OMFS) is retroactive for dates of service on and after October 14, 2020.

The Newline references the Order of the Administrative Director of the DWC, dated October 20, 2020 (Order), that conforms the Physician and Non-Physician Practitioner Services section of the OMFS to recent Medicare fee schedule changes; we covered those Medicare revisions in last week’s article, Telehealth: CMS Medicare Adds 11 New Telehealth Services. 

The Order is incorporated by reference into California Code of Regulations section 9789.19 (g) and states that “...adopting the Medicare Physician Fee Schedule October 14, 2020 expanded telehealth list will support the goal of reducing the spread of the SARS CoV-2 while increasing access to workers’ compensation medical treatment provided via telehealth.”

Telehealth Services Added Effective 10/14/2020

To help practices bill for these newly-added services, the table below sets out the short descriptors and status for each telehealth procedure code. For DaisyBillers, we have already updated the fee schedules in DaisyWizard.

Billing Tip

California providers are reminded that when billing services provided via telehealth:

• Append modifier 95 to the procedure code, and
• Bill using the Place of Service code that would have been used had the provider furnished the medical service in-person

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