Keeping Income Up During the Pandemic: Does Telehealth Really Pay?

With COVID-19 interrupting everyone's daily lives, most medical practices were forced to implement telehealth. Many major insurances expanded their telehealth benefits to make it easier for providers of most specialties to continue treating patients. Designated area requirements were removed, as were the rules regarding who could provide telehealth. Prior to the pandemic, only certain clinics and provider designations were allowed. Now, most practitioners can provide telehealth services in a variety of ways- phone calls, interactive audio/video and even virtual check-ins and e-visits. For the first time ever, even physical or occupational therapists and mental health providers can jump on the telehealth bandwagon. The key to keeping your income up during this time, is to know the facts. Below are some key points regarding telemedicine.

• Most insurances are paying the same amount for E&M codes for telemedicine as they were for face to face visits. If you are keeping your patient load similar to your pre-COVID schedule, you should not be seeing a large reduction in income. Make sure the E&M codes have the appropriate telemedicine modifier attached; many insurances have different requirements so ensure your biller does their research.

• Audio only visits pay very little in comparison to audio/video visits. Try to limit the amount of these type of visits. Also, phone calls are not covered by many insurances for providers who cannot normally bill E&M codes. There are multiple code sets you could use when billing this (99441-99443, 98966-98968) so make sure you read the description carefully to ensure you are using the right ones.

• E-visits have various code sets, as well (99421-99423, G2061-G2063). Again, read the descriptions and ensure you are using the correct ones. The reimbursement rates for these are lower than E&M visits.

If you keep your schedule as full as pre-COVID and provide audio/video visits, your income should remain relatively stable. Still have questions regarding telehealth billing? Visit our home page and reach out via email or phone. We're here to help!

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