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COVID-19 Updates & Resources

The Connecticut Podiatric Medical Association will continue to update you on resources available to help you and your practice during the novel Coronavirus pandemic.

MESSAGE FROM CPMA

April 29, 2020

Important update regarding a possible second round of HHS grants:

Greetings,
 
As part of the CARES act, $50 billion was marked for the Department of Health and Human Services to distribute to doctors and hospitals. Most of you received an HHS PAYMENT into your checking account that was calculated roughly on a formula of 6.2% of your 2019 Medicare payments. If it was not a direct deposit, then you received a check in the mail. These payments amounted to $30 billion and literally just “showed up” in our accounts or mailboxes. The money is a grant and is not expected to be paid back. Now, HHS is beginning the distribution of the remaining $20 billion in funds as grants to doctors and hospitals.  This time, the HHS PAYMENT will not be automatic!!  Click here for more details from APMA.
 
My recommendation is that you apply for these funds now. You may or may not receive anything but in order to qualify, you must go through the simple (not easy) application process. This is not necessarily a “first come, first serve” application. That said, apply now ! Once weekly, on Wednesday, all submitted applications will be reviewed. If you get a grant, your payment will be disbursed in 10 business days.
 
I became aware of this Sunday evening, researched all available information that I could find and then applied today. Once you complete the application the site will send you a confirmation email. Keep in mind that you must attest to receiving the first grant disbursement from HHS is order to fill out the application for the second grant. There is a good tutorial available here that I highly recommend you go through and gather the documents and information needed to apply.
 
Here are a few important tips as you fill this out:
 
1.    The site WILL time out so have everything ready before you start. Once you have everything it will only take you 10 minutes to complete.
 
2.    You will need your office TIN and your office Medicare number. You will need the last 6 digits of your checking account number, and you will need your exact HHS deposit that you received on the first go around. That is why you have to attest to the first round before you begin this application.
 
3.    At one point the site will send you an email verification. It will ask you on your application for an access code. This is the “signing validation code” that appears in the beginning of the email. Simply copy and paste that into the spot where they want the access code (something like d123456F) and click on the yellow highlighted area to the right of the access code. This will take you to the application.
 
4.    The actual application will want office address info and then will request your total practice income as stated on line 1a of your 2019 1120 tax form. 
 
5.    They will want to know the loss of practice income from March of 2019 to 2020 and then from April of 2019 to 2020. For most of us, March will not be much different, but April will be a big drop. Just fill in estimates. 
 
6.    Then you will have to upload your 2019 office tax returns.
 
7.    There will be a place to sign and that’s it. You should get a confirmation email right away.
 
If you already attested to your first HHS grant, as our group did, the application portal may not work the first time through so try again. Remember there are two separate portals, one to attest to the first grant and one to apply for the second…and they look almost identical. Stay with it!
 
Finally, it is not clear if small practices will get additional funding, or if the 20 billion is marked for rural hospitals, Indian Services, etc. We see no harm in applying, and if you do get a grant, you may want to set this aside in savings in case this one has some strings attached. At this time, that doesn’t appear to be the case.
 
For more information, click here .
 
Be well,
 
Marc Lederman,
Executive Director, CPMA

PREVIOUS MESSAGES

Paycheck Protection Program

Paycheck Protection Program

The Paycheck Protection Program is a federal program to provide forgivable loans. Banks will begin accepting applications on Friday, April 3rd. The program has a total funding level of $349 billion and is administered by the US Department of Treasury. Small businesses will submit applications to select banks. For more information you can click here.

Application Information:

  • Participating banks will accept and process applications.
  • Here is a link to the application.

Loan amounts are provided to businesses based on each company's payroll level. For instance, the typical loan amount will be 2.5 times average monthly payroll. During the COVID-19 period, when a company retains employees or rehires them, the principal and interest on loans provided by the program will be forgiven.

Office Hours

Podiatry offices in Connecticut may continue to be open, but the CDC recommends medical offices to discontinue elective procedures (surgical and office-based) and delay all elective ambulatory provider visits.

Health-care facilities and clinicians should prioritize urgent and emergency visits and procedures now and for the coming several weeks. As an example, some offices are seeing patients every 30 minutes and not double booking to minimize patient to patient and patient to staff contact.  You may want to notify your patient-base that you are available for emergency visits that can include fractures, sprains, infections, etc. to keep these patients away from hospitals and walk-in facilities.

TELEMEDICINE

The Centers for Medicare and Medicaid Services announced major changes to services that podiatrists can furnish remotely allowing podiatrists to submit CPT 99201-99215 when these services are provided remotely. For details click here.

Face Time and Skype may be used for telemedical purposes. HIPPA rules will not apply to telemedicine within reason during this crisis.

Office E&M Coding without modifiers may be used.

For more information on the guidelines for telemedicine, please see comments shared by Dr. David Freedman, APMA Coding Committee, here

Be sure to check your private insurance carriers for their updates on the use of telemedicine for your practice. Individual carriers may vary in their rules and regulations.

April 8, 2020 | Latest Coding News on Use of Telemedicine

I would like to thank Dr. David Freedman and Dr. Mike Fein for helping with the information.

The following will outline which codes to use and how to bill for your service:

  • For Medicare patients ONLY: (not Medicare Advantage) when billing a Telemedicine visit the proper codes are the E&M codes. Your Place of service should be 11 (office). The Place of service (POS) is equal to what it would have been had the service been furnished in-person.
  • You will also add the modifier 95, which means that the service rendered was actually performed via Telehealth.  

The billed code is based on either time or level of complexity of the call. Your documentation will be as you normally do and the time involved should take into account your time to review relevant medical tests and document properly. CMS has stated the visit is coded based on Medical Decision Making or Time.

The times are as follows:

  • 99211 5 minutes
  • 99212 10 minutes
  • 99213 15 minutes
  • 99214 25 minutes

The payments made will be the same as any billed E&M code.

Finally, if you perform a telemedicine call with a Medicare patient but are unable to secure video, and it is audio only, then the only code to use is the G2012, and no modifier is needed.

For non-Medicare insurance companies, you can still use the codes 99441, 99442 and 99443. These codes are based on time and must be with the use of video and were previously outlined. These are patient-initiated services with physicians, the patient is an established patient. These are online digital E/M services and are reported once for the physician's cumulative time devoted to the service during a seven-day period.

99421 Online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 5-10 minutes

99422 Online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 11-20 minutes

99423 Online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 21 or more minutes

It is important for all non-Medicare insurance plans that you check the Insurance company website for their specific coding requirements as there may be some nuances to one particular plan. 

Message by Marc Lederman

RESOURCES

APMA

APMA is frequently updating their Coronavirus (COVID-19) Information. Their FAQs are helpful and updated based on recommendations from the CDC and other governmental sources. Learn more.

Centers for Disease Control (CDC)

Get your practice ready. Learn more.

Information for Healthcare Professionals. Learn more.

The National Telehealth Policy Resource Center

State Telehealth Laws and Reimbursement Policies, Fall 2019. The specific laws regarding Connecticut can be found on pages 71-77. Learn more.

 

 

 

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