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Telehealth Services Claim Reporting

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The submission of new Medicare HCPCS codes (G-codes) for Telehealth services on Medicare Home Health Claims is required as of 7/1/2023. However, these codes are not counted towards a visit count to meet the LUPA threshold or in Outlier calculations.

  • G0320: home health services furnished using synchronous telemedicine rendered via a real-time two-way audio and video telecommunications system.
    • Short Descriptor: G0320: two-way audio and video HHS
  • G0321: home health services furnished using synchronous telemedicine rendered via telephone or other real-time interactive audio-only telecommunications system.
    • Short Descriptor: G0321: audio-only HHS
  • G0322: the collection of physiologic data digitally stored and/or transmitted by the patient to the home health agency (for example, remote patient monitoring).
    • Short Descriptor: G0322: Home H physio data collec tr

The use of remote patient monitoring that spans a number of days is reported as a single line item reporting the beginning date of monitoring and the number of days of monitoring in the unit's field. Agencies shall submit services furnished via telecommunications technology in line item detail, and each service must be reported as a separate line under the appropriate revenue code for each discipline furnishing the service.

Setup
  1. Create and identify non-billable Service Codes for the various Telehealth services by selecting Telehealth Visit and then the appropriate type on the General Tab.
  2. Set the Report Telehealth Services Starting on date in the Insurance Code> Billing Rules Tab.
  3. Grant the privilege to Patient > Services > Telehealth Services.
Data Collection
  1. Establish Telemonitoring reporting in the Remote Monitoring window on the PDGM Information Tab in Admissions & Status.
  2. Enter Telemonitoring services QTY in the Remote Monitoring window.
  3. Interface Telemonitoring services from Third-Party Telemonitoring solutions.
  4. Enter and verify Telehealth services through Scheduling or TimeLog.
  5. Monitor Telehealth services via Patient > Services > Telehealth Services.
Claim Processing
  • Medicare Claims report the appropriate Telehealth Services where an in-person visit exists for that discipline.
Reporting

The following reports are updated to exclude Telehealth services from LUPA and Outlier calculations:

  • Billing Register
  • Revenue and Expense
  • PDGM Revenue