TELEHEALTH, HERE WE COME!
On April 30th, 2020, CMS announced that PTs, OTs and SLPs would be deemed eligible providers of Telehealth services to Medicare beneficiaries. Currently, this status is limited to the duration of the Covid-19 Health Emergency. However, there is hope that the eligibility will continue even after the resolution of the pandemic. In addition, some commercial payers will cover these services for Rehab Therapists during the pandemic and, at least one, has announced they plan to make PT Telehealth a permanent benefit.
What’s the Difference Between Telehealth and E-Visits?
CMS had previously given permission to therapists to complete E-Visits during the pandemic. As defined by CMS, an E-Visit is a “non-face-to face patient-initiated digital communication that requires a clinical decision that otherwise typically would have been provided in the office.” This is essentially a check-in with the patient, not necessarily defined as treatment. On the other hand, CMS defines Telehealth as “the use of electronic information and telecommunications technologies to support and promote long-distance clinical health care, patient and professional health-related education, public health, and health administration.” Telehealth is, therefore, more of a traditional treatment visit, except it occurs electronically rather than in the clinic. Generally speaking, telehealth visits are reimbursed at a higher rate than e-visits. You are unable to utilize an e-visit if a face-to-face visit occurs within seven days before or within seven days after the e-visit. Some providers have found benefit in using an e-visit between telehealth visits to check-in with their patients and modify their HEP as needed.
In the midst of this pandemic, telehealth is a viable option to help therapists continue to treat their patients, as well as to continue to generate revenue. We recommend contacting your payers to verify coverage and obtain specific information regarding proper treatment codes and any modifiers that may be required, which should help to minimize billing issues. It is also a good idea to check your state’s practice act to be sure telehealth is not excluded and follow up with your malpractice insurance to be sure telehealth visits are covered. Your practice’s consent forms may also need to be updated to reflect appropriate telehealth language.
How Does it Work?
As with any new process, and pretty much everything involved with the Covid-19 Health Emergency, telehealth does come with some challenges. What’s the best platform to use to administer a telehealth visit? How do you make your patients aware of the option to participate in Telehealth visits? How do you assist a patient that is technologically challenged in joining the virtual visit? What’s the best way to document the visit?
The platform to administer telehealth visits must have audio and video capabilities. Due to the pandemic, CMS has waived the need for the platform to be HIPAA compliant. However, we highly recommend using a HIPAA compliant platform to protect your patients and yourself. In addition, this will allow you to continue to use the same platform when the health emergency ends. Some examples of HIPAA compliant programs include Zoom and Doxy.me. If you are an OptimisPT user you have the benefit of using Jitsi for no additional charge. Jitsi will also be integrated directly into OptimisPT in the near future.
Ready to Get Started?
Once you have decided to begin offering telehealth services, how do you make your patients aware? Here are a few ideas. You could have your staff make telephone calls to your patients. This method is a little more time consuming, but could be effective. Updating all of your social media accounts to indicate your clinic offers telehealth services would be a way to inform your current clients, as well as, potentially gaining new patients. If you use an EMR that has mass emailing capabilities, like OptimisPT, you could quickly communicate to your active patients, as well as former patients. Another important aspect is to market to your referral sources. You can pull physician referral reports from your EMR and contact those physicians. If they know you are providing telehealth services, they may be more apt to prescribe necessary therapy services to their patients during the pandemic, knowing there would be no direct contact that may put their patients at risk for contracting Covid-19.
You may have some patients that are technologically challenged or are hesitant to try a telehealth visit. In these cases, it may help to encourage the patient to try at least one session. If they don’t like it, then they don’t have to participate in additional sessions. If they are worried about the technology aspects, do your best to provide clear instructions ahead of the visit and be prepared to trouble shoot with the patient, if issues arise. A little patience and encouragement on your end will go a long way in making your patient feel comfortable with the new treatment delivery method.
Documentation of telehealth visits should follow best documentation practices currently used when completing in-person therapy visits. You should continue to use a SOAP note format following state license and payer requirements. You would want to include in your note that the visit was performed via telehealth and that the patient consented to a telehealth visit. If using OptimisPT as your EMR you can select the visit type of “Telehealth.” This allows your clinic to easily categorize and pull statistics related to these services.
During this Covid-19 pandemic, clinicians are challenged to find safe ways to continue to care for their patients, as well as to find ways to keep their businesses viable. Thanks to the approval by CMS for PTs, OTs, and SLPs to be eligible providers of Telehealth services, Telehealth offers a potential opportunity for therapists during the pandemic and possibly beyond. If you are a current OptimisPT user and would like to learn more, please click on the orange Support button within the system. On the other hand, if your current EMR does not offer features to accommodate Telehealth, or you are currently documenting on paper, we encourage you to take a look at OptimisPT. We are continuously updating the functionality of our system to meet the needs of our users within the ever-changing healthcare environment. To schedule a demo, please visit our website at www.optimispt.com.
In addition, if you would like to advocate for continued access to telehealth services provided by therapists after the resolution of the Covid-19 health emergency, we encourage you to visit www.apta.org.