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August 14, 2020

COVID-19 Telehealth Updates

August 14

The Colorado Division of Workers’ Compensation adopted amendments to Rule 18-3 General Policies, and 18-4 Professional Fees and Services, of the 2020 Medical Fee Schedule. Adopted amendments are specific to telemedicine including, updating place of service codes, reimbursement rates, and expanding the scope of services that may be provided.

Earlier this year, and in response to COVID-19, the Division issued a temporary telemedicine rule and these amendments make official updates to the 2020 Medical Fee Schedule. These rules are effective beginning October 14, 2020.

The Texas Division of Workers’ Compensation (DWC) announced a 60-day extension of emergency rules telemedicine rules created in response to COVID-19.

Effective August 21, 2020, the rule extension will continue to allow healthcare providers licensed to perform physical medicine and rehabilitation services, including physical therapists, occupational therapists, and speech pathologists, to bill and be reimbursed for services allowed under CMS telemedicine and telehealth billing codes. Meanwhile, New York posted the adoption of emergency amendments to supersede previous emergency telemedicine rules, which are effective July 20, 2020 through October 18, 2020. Notice of Emergency adoption was published in the August 5, 2020 edition of the State Register.

May 11: Utah & Illinois Issue Rules, Connecticut Issues Rule Clarity

The Utah Labor Commission published new bulletin adopting emergency telemedicine rules and defining reimbursement rates. The rules specify that, unless otherwise governed by contracts, payors must reimburse providers at the same rate as comparable in-person services for various CPT codes. These rules will be effective April 13, 2020 and will remain effective for 120 days, with an expected expiration date of August 11, 2020.

The Illinois Workers’ Compensation Commission (IWCC) posted a notice temporarily adopting CPT codes eligible for a telehealth modifier, expanding the range of codes that can be rendered via telecommunications.

Connecticut, which previously issued emergency telehealth rules, has issued a new memo regarding the reimbursement of telemedicine services to provide greater clarity in which reimbursement rates to utilize for telehealth services.

Several states have adjusted their regulations to better embrace telehealth and reduce the spread of coronavirus by keeping injured workers from unnecessarily going out and increasing their likelihood of exposure. More states may continue follow suit soon, as the Center for Medicare and Medicaid Services (CMS) expanded access to telemedicine. As many states follow CMS standards, these changes have the potential to trickle down.

As more states continue to relax requirements for coverage of telehealth services to help increase access to needed medical care, we will continue to update our reporting of these changes. The following states have updated telehealth rules:

April 27, 2020: Massachusetts and Rhode Island Issues Rules, New York Revises Theirs

Massachusetts’ Office of Labor and Workforce Development issued an administrative bulletin allowing telehealth services in workers’ comp until the State of Emergency is lifted by Governor Charlie Baker. Special codes are outlined in the bulletin, to be used when telemedicine treatment is reasonable, necessary, and appropriate.

The Rhode Island Department of Labor and Training (DLT) published workers’ comp medical fee schedule rules for telehealth and telemedicine, stemming from Executive Order 20-06 which suspended rules limiting telemedicine, requiring carriers to cover these services. The rules include telemedicine codes that have been assigned temporary fee schedule reimbursement rates.

New York’s Workers’ Compensation Board adopted emergency telemedicine amendments that supersede previous emergency rules issued in March.

Several states have adjusted their regulations to better embrace telehealth and reduce the spread of coronavirus by keeping injured workers from unnecessarily going out and increasing their likelihood of exposure. More states may continue follow suit soon, as the Center for Medicare and Medicaid Services (CMS) expanded access to telemedicine. As many states follow CMS standards, these changes have the potential to trickle down.

As more states continue to relax requirements for coverage of telehealth services to help increase access to needed medical care, we will continue to update our reporting of these changes. The following states have updated telehealth rules:

April 20, 2020: Wyoming Joins; Arizona and Texas Double Down

Wyoming’s Department of Workforce Services published a Provider Bulletin to their website regarding telehealth visits, stating that such visits are considered the same as in-person visits and must be reimbursed the same as well. The bulletin also includes a complete list of telehealth service codes and other information.

Arizona Doug Ducey Governor signed Executive Order 2020-29, which increased telemedicine access for workers’ comp, requiring carriers to provide coverage for all healthcare services that can be provided via telemedicine. The order allows carriers to establish reasonable requirements and parameters for telehealth service, including documentation, recordkeeping, and more. Previously, Arizona’s Industrial Commission adopted new fee schedules related to COVID-19, including new codes for telehealth. This order increases access to telehealth more so than the previous action.

And in Texas, where Governor Abbot previously waived certain regulations for telemedicine care, the Department of Insurance adopted a new administrative code on an emergency basis, going into effect April 13th, which builds upon previous telehealth expansion. This new adoption now includes physical medicine and rehabilitation services, which were not included in CMS revisions, which serve as a model for other states.

Several states have adjusted their regulations to better embrace telehealth and reduce the spread of coronavirus by keeping injured workers from unnecessarily going out and increasing their likelihood of exposure. More states may continue follow suit soon, as the Center for Medicare and Medicaid Services (CMS) expanded access to telemedicine. As many states follow CMS standards, these changes have the potential to trickle down.

As more states continue to relax requirements for coverage of telehealth services to help increase access to needed medical care, we will continue to update our reporting of these changes. The following states have updated telehealth rules:

Newest States Added: California, Tennessee, Vermont

Several states have adjusted their regulations to better embrace telehealth and reduce the spread of coronavirus by keeping injured workers from unnecessarily going out and increasing their likelihood of exposure.

More states may continue follow suit soon, as the Center for Medicare and Medicaid Services (CMS) expanded access to telemedicine. As many states follow CMS standards, these changes have the potential to trickle down.

As more states continue to relax requirements for coverage of telehealth services to help increase access to needed medical care, we will continue to update our reporting of these changes.

The following states have updated telehealth rules:

Several states have adjusted their regulations to better embrace telehealth and reduce the spread of coronavirus by keeping injured workers from unnecessarily going out and increasing their likelihood of exposure.

As more states continue to relax requirements for coverage of telehealth services to help increase access to needed medical care, we will continue to update our reporting of these changes.

April 10, 2020: Georgia, Montana, Michigan

The Georgia State Board of Workers’ Compensation (SBWC) has provided guidance for the provision of select services via telemedicine during the COVID-19 pandemic. The Board has provided a list of codes eligible to be provided via telemedicine if the patient is non-emergent and the provider and patient agree to the medical appointment being handled via telemedicine. The Board also provides information on maximum allowable reimbursement for telemedicine services.

The Montana Department of Labor & Industry announced temporary changes to previously existing telemedicine regulations expanding the services that can delivered electronically, while also adjusting billing procedures. Expanded services include triage, initial injury or urgent evaluation on an on-demand basis, follow-up care, psychological services, return to work evaluations, medication management, and more.

Michigan’s Disability Compensation Agency notified carriers that they must provide increased access to healthcare services via telemedicine delivery platforms to limit in-person care when possible. Carriers are encouraged to work with providers to consider telemedicine when possible, and to modify payment and coverage policies regarding telemedicine furnished by physical, occupational, and speech therapists. The agency also encourages reimbursement rates for telerehab to mirror payment rates for equivalent services provided in person, or that providers and carriers quickly agree on reasonable rates.

The Florida Division of Workers’ Compensation (DWC) declared that they are following the lead of an emergency order published by the Florida Department of Health, which suspends certain statutes and rules to better embrace telemedicine. According to the order, the provision of telehealth services must be mutually agreed upon by the carrier and healthcare provider, utilizing national coding standards from CMS.

These states join others that have embraced telehealth, including:

More states may likely follow suit soon, as the Center for Medicare and Medicaid Services (CMS) expanded access to telemedicine. As many states follow CMS standards, these changes have the potential to trickle down.

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