Table 1.

AMDA–The Society for Post-Acute and Long-Term Care Medicine Guidance for Submitting Claims for Telehealth Services During COVID-19 in the Nursing Home Setting to Reflect

COVID-19 Telehealth Waivers • Originating sites (where nursing home residents are located) no longer need to be in rural locations as defined by the Health Resources and Services Administration (HRSA) during any portion of any COVID-19 public health emergency period ○ Nursing homes can bill Q3014 as an originating site (payment approximately $26 per encounter) •Post-acute and long-term care clinicians do not need to demonstrate prior relationship with the patient, ie, at least 1 encounter in the past 3 years by the same provider or other qualified provider in the same practice (as determined by tax ID) • Changes and clarification to distal site (where the qualified practitioner is located) requirements are as follows: ○ For practitioner doing the visit: - Use appropriate CPT E&M nursing facility code (99304-99310, 99315/16) - Use appropriate Place of Service (POS) Code: 31, skilled nursing facility; 32, nursing facility - Use modifier 95 to indicate visit done via telehealth - Conduct telehealth visits “as appropriate” - Initial visit (99304-99306) can be completed by physician assistant/nurse practitioner during the public health emergency - Must obtain consent from patient or designated surrogate (can be verbal) for conducting telehealth visits - Can waive any copay associated with the visit

CPT, Current Procedural Terminology; E&M, evaluation and management.

Adapted from https://paltc.org/telehealth-paltc (accessed June 5, 2020).