Using Telehealth to Care for Patients During the COVID-19 Pandemic

May 1 Update:
CMS Boosts Telephone Payments

Following AAFP advocacy(www.acponline.org), CMS has increased the payment rate and RVUs for telephone E/M services (CPT codes 99441-99443), retroactive to March 1, 2020.

The RVUs and payment rates for telephone E/M services align with outpatient/office visit E/M codes 99212-99214, with new rates ranging from $46 to $110.

Fighting for Family Medicine: AAFP Advocates for CMS to Relax Key Regulations

After the AAFP advocated for telehealth latitude(2 page PDF), CMS announced on March 30 plans to temporarily relax a number of key regulations.

This will help family physicians better respond to the COVID-19 pandemic and includes other measures to relieve administrative burden and reinforce staffing.

COVID-19 banner

Updated June 2, 2020

Telemedicine and virtual care have quickly become important tools in caring for your patients while keeping yourself and your staff safe as the COVID-19 pandemic quickly evolves. Here is what you need to know when providing telehealth services.

Implementing Telehealth and Telemedicine Service in My Practice

Expansion of Telehealth and Licensing Waivers During the COVID-19 Pandemic

Coding for COVID-19

The AAFP has put together information on how to code for different types of COVID-19 scenarios, including telehealth, in-person, and audio-only.

Telemedicine Payment

The Centers of Medicare & Medicaid Services (CMS) has loosened the regulations for telemedicine in response to the COVID-19 pandemic. Telehealth services may now be delivered to Medicare beneficiaries by phone as long as video capability is available. 

Review the links below for more information and read more in FPM.

May 1 Update:
CMS Boosts Telephone Payments

Following AAFP advocacy(www.acponline.org), CMS has increased the payment rate and RVUs for telephone E/M services (CPT codes 99441-99443), retroactive to March 1, 2020.

The RVUs and payment rates for telephone E/M services align with outpatient/office visit E/M codes 99212-99214, with new rates ranging from $46 to $110.

Telemedicine Companies

Providing care virtually doesn’t have to be complicated!

Beginning on March 6, 2020, Medicare — administered by the Centers for Medicare & Medicaid Services (CMS) — will temporarily pay clinicians to provide telehealth services for beneficiaries residing across the entire country. For more information please see the FAQ(edit.cms.gov) and Guidance(www.medicaid.gov). It removes the telehealth stipulation that telehealth can only be provided in rural areas with specific audio-visual equipment.

It's as simple as using your phone, smartphone or laptop with a shared link to enable video, or other electronic devices. Free to low-cost telehealth platform options are available. As of the March 17 HHS OCR announcement(www.hhs.gov), effective immediately (and during the COVID-19 National Public Health Emergency) you may use popular apps that allow for video chats, including Apple FaceTime, Facebook Messenger video chat, Google Hangouts video, and Skype, to provide telehealth without risk that OCR might impose penalties for noncompliance with HIPAA.

Note: Facebook Live, Twitch, TikTok, and similar video communication apps that are public facing should not be used to provide care virtually.

Fighting for Family Medicine: AAFP Advocates for CMS to Relax Key Regulations

After the AAFP advocated for telehealth latitude(2 page PDF), CMS announced on March 30 plans to temporarily relax a number of key regulations.

This will help family physicians better respond to the COVID-19 pandemic and includes other measures to relieve administrative burden and reinforce staffing.

Telehealth Technology

AAFP does not endorse specific products or companies and of course recommend carrying out your own due diligence in investigating, but telehealth platforms we are aware of members using in private practice include:

Doxy.me(doxy.me) – Self-touted to be “a simple, free, and secure telemedicine solution.” The AAFP understanding is Doxy.me has a “freemium” business model, with a free base option and other options available at cost a la carte.

eVisit(evisit.com) – The AAFP has heard member reports eVisit ranges from $50/month to $150/month.

SimpleVisit(simplevisit.com)  – The AAFP has heard SimpleVisit runs approximately $150/month. 

VSee(vsee.com) – The VSee site notes one can “get it free," though the AAFP has heard members report it costing up to $250/month.

Mend NOW Telehealth(www.mendfamily.com) – Pricing is advertised as starting at approximately $49 a month, with a seven-day free trial. Mend says its product does not requre a software download and is HIPAA-compliant. Pricing is available here(www.mendfamily.com). Complete this form(www.mendfamily.com) to request a demo.

Spruce Health(www.sprucehealth.com) – Spruce Health is often used by direct primary care (DPC) family medicine practices. Its telehealth capabilities are integrated with Elation Health EHR, though Spruce can be used alongside other EHRs without integration with EHR. The AAFP is not yet aware of pricing info.

Exploring telehealth platforms? Asks vendors these questions.

The AAFP is gathering answers to these questions across vendors:

  • Can I exit my contract at any time (i.e., not locked into a 2-year contract)?
  • Is there a waiting room feature so I can queue my patients up?
  • Is the platform device agnostic (i.e., can physicians/providers and patients use device of their choosing for virtual care)?
  • Is there an out-of-office message noting we’re not available to take your call right now? (i.e., during off hours or overnight)?
  • Does the software have the ability to schedule a visit? Note: This is a more advanced feature; it's not absolutely required to have now, but it's very nice to have
  • Is the platform deployable in days?

Frequently Asked Telehealth Questions

Telehealth and telemedicine can be confusing to navigate, especially during the COVID-19 pandemic. We have gathered our top questions to get you the exact info you need to bill and code telehealth correctly.