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Telehealth Guidance Revised - Modifier CS to be Used for Preventive Services Furnished via Telehealth
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7/6/2020 @ 6:26:00 PM
Post 1 of 2

Contributor: Nathan Baugh, National Association of Rural Health Clinics

Telehealth Guidance Revised!

Today, CMS revised MLN Matters SE 20016 to clarify that RHCs should use modifier CS to waive cost sharing for preventive services furnished via telehealth.

https://www.cms.gov/files/document/se20016.pdf


Unfortunately, this does not solve our problem with Annual Wellness Visits performed via telehealth in RHCs not being properly accounted for under current billing guidance.


 

This revised guidance also makes it clear that MACs have the authority to offer productivity standard exceptions, and further guidance from the MACs is forthcoming.

7/13/2020 @ 3:51:00 PM
Post 2 of 2

Contributor: Stephanie Wyatt, UnityPoint Health Corporate IT

After reviewing the revised guidance how is everyone else handling if there is a problem visit (telehealth) as well as an AWV (telehealth) during the same encounter? My assumption is that both codes would "roll up" under the G2025 but per the guidance we would only want the CS attached to the portion specific to the AWV? The cost share for the problem visit should not be waived (unless of course it was related to COVID), correct?  How can this be done if the services are to be reported under G2025?Any insight anyone has is very much appreciated. Thank you!

---------- Original Comments ----------


Last Post By: Nathan Baugh, National Association of Rural Health Clinics

Telehealth Guidance Revised!

Today, CMS revised MLN Matters SE 20016 to clarify that RHCs should use modifier CS to waive cost sharing for preventive services furnished via telehealth.

https://www.cms.gov/files/document/se20016.pdf


Unfortunately, this does not solve our problem with Annual Wellness Visits performed via telehealth in RHCs not being properly accounted for under current billing guidance.


 

This revised guidance also makes it clear that MACs have the authority to offer productivity standard exceptions, and further guidance from the MACs is forthcoming.


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