Please note that this article contains information that is only relevant to American clinics. 

 

As we know, Medicare and Medicaid are designed to help some of the most at-risk individuals across America. Given that the COVID-19 outbreak has officially been deemed a Public Health Emergency, the CMS has made a number of changes to help accommodate both therapists and their patients during these challenging times. In this article, we’ll be highlighting several of such changes.

 

MIPS

 

The first change we’ll be discussing is related to MIPS. The CMS has extended the 2019 MIPS data submission deadline by 30 days to April 30, 2020 at 8:00 pm EST. Originally it was slated for March 31, but given the current situation, the CMS will be offering some slack.

 

MIPS eligible clinicians identified as affected by the automatic extreme and uncontrollable policy will have all four performance categories re-weighted to 0% of their final score unless they submit data for two or more performance categories.  The affected MIPS eligible clinicians will receive a neutral payment adjustment for 2021 Payment Year. Fortunately there is no additional action required by clinicians to ensure this.

 

It’s also important to note that the CMS has not published guidelines regarding any changes in MIPS 2020 Performance Year requirements yet, and at this point, we are unsure if they will.

 

Telehealth

 

Since many clinicians no longer have the ability to treat patients in person, they’re turning to video conferencing applications so that they can provide them with instruction and some form of care. This is known as telehealth. Many insurers will cover these services – you will have to check each insurer as well as your state regulators for information.

 

The CMS has also made some changes to their policy regarding telehealth.

 

They’ve taken the step of adding many CPT codes to their list of covered telehealth services. You can access the full list here. And while this is great news, unfortunately only certain types  of providers are allowed to bill Telehealth.  At the time of writing PT’s OT’s and SLP’s in private practice are currently not covered by CMS for telehealth where telehealth is synchronous (real-time) video conferencing.

 

CMS will be allowing these therapists to perform telephone therapy  as well as asynchronous (e.g. email, reports, documents) therapy and to bill for these services. Please check with your professional association and on the CMS website for additional information about the interim ruling.  It’s yet to be seen if these changes regarding telehealth will remain in place after the COVID 19 pandemic has passed.

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