Telemedicine Services During the COVID-19 Crisis
CMS Coronavirus Resources, Forms, and Statements includes billing guidance
|Type of Service||What is the Service||HCPCS/CPT Code||Patient Relationship with Provider|
|MEDICARE TELEHEALTH VISITS||A visit with a provider that uses telecommunication systems between a provider and a patient.||
Common telehealth services include:
For new* or established patients.
*To the extent of the 1135 waiver requires an established relationship, HHS will not conduct audits to ensure that such a prior relationship existed for claims submitted during this public emergency.
|VIRTUAL CHECK-IN||A brief (5-10 minutes) check in with your practitioner via telephone or other telecommunications device to decide whether an office visit or other service is needed. A remote evaluation of recorded video and/or images submitted by an established patient.||
||For established patients.|
|E-VISITS||A communication between a patient and their provider through an online patient portal.||
||For established patients.|
Teladoc Telemedicine/Telehealth Services
Visit Teladoc.com/coronavirus for the most current information regarding telemedicine services.
Yes. Consistent with recommendations from the CDC, if the doctor observes symptoms and risk factors that suggest COVID‐19, s/he now has the ability to add a notation to the “excuse note” advising the patient to self‐quarantine for 14 days. (Clients continue to have the ability to suppress excuse note capabilities at the group level.)
No. Given demand for medical care during this outbreak, we are not able to re‐evaluate healthy patients and issue return‐to‐work notes.
Yes. During the COVID‐19 outbreak, our doctors have the ability to approve 30‐day prescription refills for chronic conditions whenever medically appropriate to do so. Maximum prescription refill duration will be 90 days. Physicians continue to evaluate clinical appropriateness, consider patient safety, and use professional judgement when approving any refill requests.
We are following the evolving guidance for use of ICD‐10 codes. Because Teladoc Health does not test and therefore cannot diagnose COVID‐19, suspected cases are coded using appropriate ICD‐10‐CM codes related to the upper respiratory and related symptoms observed and, as applicable, secondary ICD‐10‐CM codes such as: Z20.828 for “Contact with and (suspected) exposure to other viral communicable diseases,” Z20.89 for “Contact with and exposure to other communicable diseases,” Z20.9 for “Contact with and exposure to unspecified communicable disease.” As patients self‐report to our doctors that they have tested and are confirmed as COVID positive, we will utilize the new ICD‐ 10‐CM codes for respiratory illness with confirmed COVID‐19 diagnosis such as J12.89 for “Pneumonia, confirmed due to COVID‐19,” J20.8 for “Acute bronchitis confirmed as due to COVID‐19, and J22 for “Lower respiratory infection, confirmed as due to COVID‐19”, and J40 for “Bronchitis, not specified as chronic or acute, confirmed as due to COVID‐19.”
Increased demand is taxing the entire healthcare system and virtual care is not immune to that trend. Where public health officials and healthcare organizations have encouraged the use of virtual care and communities have implemented mobility restrictions for citizens, we have seen visit volumes, questions, and registration requests rapidly escalate.
As we serve members at unprecedented scale, our platform and operational functions are performing well. Our technology remains stable; our member service agents offer a first‐line of information and reassurance; and our doctors are taking care to spend more time with patients, answering questions and assessing needs.
We have seen response times exceed our normal standards – moving from minutes to hours in many parts of the country. To address elevated demand and surges in visit requests, we are implementing three key strategies:
- Optimizing physician capacity: We are grateful for and impressed by the dedication of our doctors who working tirelessly to serve rising demand. To streamline the work for our doctors, we have enhanced our technology to help them efficiently address COVID‐19 cases and supply patients with home care information, automate suspected COVID‐19 case reporting, and approve 30‐day prescription refills and extend 90‐day refills where appropriate. To serve escalating demand, we are rapidly onboarding more high‐quality board‐certified physicians to our network and activating our existing physician network to drive increased consult availability.
- Temporarily streamlining how people access and receive care: At this time, we are focused on serving on‐demand visits and have paused the scheduled visits option. Video visit requests may be converted to phone visits for faster response. To accelerate customer service, we are encouraging members to make visit requests by mobile App or web rather than by phone for efficient response. For those who choose to call Teladoc, we have implemented technology that enables a callback from a service representative rather than waiting on hold. And after a visit request is initiated, members are encouraged to be available and ready to promptly answer our callbacks, as requests will be considered cancelled after 2 unanswered callback attempts by a doctor.
- Managing member expectations and experience: We realize that long wait times can be frustrating, especially when you’re not feeling well. By setting realistic expectations with members upfront and throughout their journey, we have helped people understand these challenges and be patient as they await care from the safety of their homes. Our phone, website, and App messaging transparently share that we are experiencing high visit volumes and provide useful information about COVID‐19 while members wait to connect with a doctor. Service communications are being deployed to assure waiting members that they remain in queue and periodic outreach asks members to confirm that they still need to talk to doctor, helping us to efficiently allocate doctors’ time to active, unabandoned visits requests.