Telehealth: Video vs Audio Explained for California Workers' Comp

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Telehealth: Video vs Audio Explained for California Workers' Comp

In our most recent webinar, California Workers’ Comp Telehealth Made Easy, we reviewed the Medicare and California Division of Workers’ Compensation (DWC) rules for providing medical treatment via telehealth.

In this webinar, we discussed how, for California workers’ comp telehealth services, under all circumstances, the DWC requires a video connection. Per the DWC Newsline issued on March 28, 2020: “Telehealth options include remote visits via video-conferencing, video-calling or similar such technology that allows each party to see each other via a video connection.” Audio-only is never considered a telehealth service; audio-only is a telephone call.

Edit 5/14/2020: On 5/7/2020 the California Division of Workers’ Comp Administrative Director, George P. Parisotto, issued a new Order retroactively changing the reimbursement calculation for telehealth services. Some of the information on this page may not be correct, depending on the date of service. For the latest reimbursement rules, consult the latest Administrative Orders here and check our dedicated COVID-19 page for updates.

Many work comp providers have contacted us with questions about whether the Medicare telehealth rules apply to California workers’ compensation telehealth services. The answer to this question is Medicare telehealth rules only apply to California workers’ compensation if the DWC Administrative Director adopts the actual Medicare telehealth rule.

To date, the DWC has adopted only a single Medicare telehealth rule. Like Medicare, California workers’ comp telehealth services are reimbursed as though the provider furnished the service from a facility place of service. By designating telehealth as a facility place of service, providers are reimbursed at a substantially lower rate for telehealth services than the amount allowed for furnishing the same service in an office setting.

While Medicare recently announced it is allowing providers to furnish sixteen telehealth evaluation services via audio -- instead of requiring a video connection -- the California DWC has not adopted a similar Medicare audio exception for any services furnished via telehealth.

To repeat the answer to our most frequently asked question: For California workers’ comp telehealth medical treatment, the DWC requires each party to see each other via a video connection, at least as of the date of this blog post. We will keep you informed should this video requirement change.

To learn about why E-billing is critical during COVID-19 and the details of how workers' comp E-billing is different from group health or Medicare, sign-up for our free upcoming webinar below.

For more on telehealth rules for Medicare, California health insurers, and California workers’ compensation, look through the free resources available on our COVID-10 page.


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