Skilled Nursing Facility

CMS: Pay attention to telehealth billing rules

CMS is reminding providers to ensure that Medicare claims for telehealth are correctly billed. The agency issued broadly expanded telehealth services as part of its response to the COVID-19 public health emergency.

However, a 2018 Office of Inspector General audit found that CMS paid practitioners for some telehealth claims that did not meet Medicare requirements and that Medicare could have saved more than $3 million from 2014 to 2015 if telehealth claims had been billed appropriately.

CMS recommends that organizations review the agency’s most recent guidance on telehealth billing, including the Medicare Coverage and Payment of Virtual Services video and the list of covered telehealth services. Organizations should also refer to CMS’ COVID-19 FAQs on Medicare fee-for-services billing for answers to specific questions about billing for telehealth services under a COVID-19 emergency waiver. The agency has also published a list of general telehealth resources, including general and site-specific telehealth toolkits and information on Medicaid and CHIP telehealth billing.