Audio-Only Telehealth Now Permitted in CA - Part 3

May 18, 2020 5 min read

By: Catherine Montgomery

Audio-Only Telehealth Now Permitted in CA - Part 3

This is the third of our series on retroactive telehealth rule changes announced by the California Department of Workers’ Compensation (DWC) on 5/12/2020. Today we focus on the telehealth services which now allow audio-only as the method of interaction with the patient.

This is a three-part series of posts explaining the recent changes to allowed telehealth services and the reimbursement consequence of these rule changes.

This series covers the three major changes announced by the DWC:

Part 1 addressed the retroactive update to the Place of Service Code that is reported on the CMS 1500 when a provider furnishes telehealth services.
Part 2 analyzed the increased reimbursement for telephone CPT codes 99441 – 99443.
Today we address the adoption of the CMS updated Covered Telehealth Services, including newly added audio telehealth services.

Medicare Eliminates Video Requirements for Selected Telehealth Services

On April 30, 2020, CMS added new services to its List of Telehealth Services that are eligible for reimbursement when furnished via telehealth. Even more importantly, Medicare acknowledged that audio-only medical services are more prevalent than anticipated. CMS further conceded that when many patients are unable to communicate using video technology, providers are forced to use audio-only communications (aka “telephones”) as the only alternative to an in-person or video telehealth visit.

For certain behavioral health counseling and educational services telehealth services, CMS is waiving the requirements for use of interactive video telecommunications systems to furnish the telehealth service. This waiver allows the use of audio-only equipment to furnish services described by the codes.

California DWC Adopts Audio-Only Telehealth Services

Following Medicare’s lead, the 5/7/2020 Administrative Director Order amends California Code of Regulations, section 9789.19, subdivision (g) to allow audio-only telehealth communications.

Prior to the 5/7/2020 change, the DWC required providers to furnish all telehealth services using interactive video telecommunications systems. To the extent a patient could not accommodate a video visit, the provider was expected to furnish an audio-only telephone evaluation and to report this audio encounter with time-based telephone codes CPT 99441 through CPT 99443.

This DWC change allows the use of audio-only equipment to furnish services described by the codes listed in the table below.

Unless provided otherwise, other services included on the Medicare telehealth services list must still be furnished using, at a minimum, audio and video equipment permitting two-way, real-time interactive communication between the patient and distant site physician or practitioner.

To the extent an ill or injured worker cannot participate in video telehealth treatment, a provider is allowed to furnish audio-only evaluation. In Part 2 of this series, we discuss the reimbursement for these telephone services.

Code	Short Descriptor	Status	Can Audio-Only Interaction Meet Requirements?
90853	Group psychotherapy	Temporary Addition for the PHE for the COVID-19 Pandemic	Yes
92507	Speech/hearing therapy	Temporary Addition for the PHE for the COVID-19 Pandemic	Yes
92521	Evaluation of speech fluency	Temporary Addition for the PHE for the COVID-19 Pandemic	Yes
92522	Evaluate speech production	Temporary Addition for the PHE for the COVID-19 Pandemic	Yes
92523	Speech sound lang comprehen	Temporary Addition for the PHE for the COVID-19 Pandemic	Yes
92524	Behavral qualit analys voice	Temporary Addition for the PHE for the COVID-19 Pandemic	Yes
96130	Psycl tst eval phys/qhp 1st	Temporary Addition for the PHE for the COVID-19 Pandemic	Yes
96131	Psycl tst eval phys/qhp ea	Temporary Addition for the PHE for the COVID-19 Pandemic	Yes
96132	Nrpsyc tst eval phys/qhp 1st	Temporary Addition for the PHE for the COVID-19 Pandemic	Yes
96133	Nrpsyc tst eval phys/qhp ea	Temporary Addition for the PHE for the COVID-19 Pandemic	Yes
96136	Psycl/nrpsyc tst phy/qhp 1st	Temporary Addition for the PHE for the COVID-19 Pandemic	Yes
96137	Psycl/nrpsyc tst phy/qhp ea	Temporary Addition for the PHE for the COVID-19 Pandemic	Yes
96138	Psycl/nrpsyc tech 1st	Temporary Addition for the PHE for the COVID-19 Pandemic	Yes
96139	Psycl/nrpsyc tst tech ea	Temporary Addition for the PHE for the COVID-19 Pandemic	Yes
97535	Self care mngment training	Temporary Addition for the PHE for the COVID-19 Pandemic	Yes
92508	Speech/hearing therapy	Temporary Addition for the PHE for the COVID-19 Pandemic—Added 4/30/20	Yes
96121	Nubhvl xm phy/qhp ea addl hr	Temporary Addition for the PHE for the COVID-19 Pandemic—Added 4/30/20	Yes
96127	Brief emotional/behav assmt	Temporary Addition for the PHE for the COVID-19 Pandemic—Added 4/30/20	Yes
96158	Hlth bhv ivntj indiv 1st 30	Temporary Addition for the PHE for the COVID-19 Pandemic—Added 4/30/20	Yes
99441	Phone e/m phys/qhp 5-10 min	Temporary Addition for the PHE for the COVID-19 Pandemic—Added 4/30/20	Yes
99442	Phone e/m phys/qhp 11-20 min	Temporary Addition for the PHE for the COVID-19 Pandemic—Added 4/30/20	Yes
99443	Phone e/m phys/qhp 21-30 min	Temporary Addition for the PHE for the COVID-19 Pandemic—Added 4/30/20	Yes
90785	Psytx complex interactive		Yes
90791	Psych diagnostic evaluation		Yes
90792	Psych diag eval w/med srvcs		Yes
90832	Psytx w pt 30 minutes		Yes
90833	Psytx w pt w e/m 30 min		Yes
90834	Psytx w pt 45 minutes		Yes
90836	Psytx w pt w e/m 45 min		Yes
90837	Psytx w pt 60 minutes		Yes
90838	Psytx w pt w e/m 60 min		Yes
90839	Psytx crisis initial 60 min		Yes
90840	Psytx crisis ea addl 30 min		Yes
90845	Psychoanalysis		Yes
90846	Family psytx w/o pt 50 min		Yes
90847	Family psytx w/pt 50 min		Yes
96116	Nubhvl xm phys/qhp 1st hr		Yes
96156	Hlth bhv assmt/reassessment		Yes
96159	Hlth bhv ivntj indiv ea addl		Yes
96160	Pt-focused hlth risk assmt		Yes
96161	Caregiver health risk assmt		Yes
96164	Hlth bhv ivntj grp 1st 30		Yes
96165	Hlth bhv ivntj grp ea addl		Yes
96167	Hlth bhv ivntj fam 1st 30		Yes
96168	Hlth bhv ivntj fam ea addl		Yes
96168	Hlth bhv ivntj fam ea addl		Yes
97802	Medical nutrition indiv in		Yes
97803	Med nutrition indiv subseq		Yes
97804	Medical nutrition group		Yes
99354	Prolong e&m/psyctx serv o/p		Yes
99355	Prolong e&m/psyctx serv o/p		Yes
99356	Prolonged service inpatient		Yes
99357	Prolonged service inpatient		Yes
99406	Behav chng smoking 3-10 min		Yes
99407	Behav chng smoking > 10 min		Yes
99497	Advncd care plan 30 min		Yes
99498	Advncd care plan addl 30 min		Yes
90785	Psytx complex interactive		Yes
G0108	Diab manage trn per indiv		Yes
G0109	Diab manage trn ind/group		Yes
G0270	Mnt subs tx for change dx		Yes
G0296	Visit to determ ldct elig		Yes
G0396	Alcohol/subs interv 15-30mn		Yes
G0397	Alcohol/subs interv >30 min		Yes
G0406	Inpt/tele follow up 15		Yes
G0407	Inpt/tele follow up 25		Yes
G0408	Inpt/tele follow up 35		Yes
G0420	Ed svc ckd ind per session		Yes
G0421	Ed svc ckd grp per session		Yes
G0425	Inpt/ed teleconsult30		Yes
G0426	Inpt/ed teleconsult50		Yes
G0427	Inpt/ed teleconsult70		Yes
G0436	Tobacco-use counsel 3-10 min		Yes
G0437	Tobacco-use counsel>10min		Yes
G0438	Ppps, initial visit		Yes
G0439	Ppps, subseq visit		Yes
G0442	Annual alcohol screen 15 min		Yes
G0443	Brief alcohol misuse counsel		Yes
G0444	Depression screen annual		Yes
G0445	High inten beh couns std 30m		Yes
G0446	Intens behave ther cardio dx		Yes
G0447	Behavior counsel obesity 15m		Yes
G0459	Telehealth inpt pharm mgmt		Yes
G0506	Comp asses care plan ccm svc		Yes
G0513	Prolong prev svcs, first 30m		Yes
G0514	Prolong prev svcs, addl 30m		Yes
G2086	Off base opioid tx 70min		Yes
G2087	Off base opioid tx, 60 m		Yes
G2088	Off base opioid tx, add30		Yes

For a comprehensive look at recent changes to telehealth rules for both Medicare and CA workers’ comp, watch our free webinar. Major reimbursement increases and expansion of audio-only services are just the beginning.

WATCH THE WEBINAR

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