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Arizona Chapter Payer Relations Update

Published: Apr 22, 2020

I am enclosing the current “up-to-date” telehealth/telerehab information. This list includes Modifiers and POS needed to bill the various insurances.

Please note that this is only meant as an aid for your practice, not a guarantee of payment for what providers bill. Please remember to verify billing details for telehealth with each payer. This list and information are literally changing weekly and at times daily.

 Medicare is NOT paying for telehealth visits at this time. They will pay for “E visits” through a patient portal with the communication being initiated by the patient through the portal. They will also pay for a group of telephonic codes. Each of the above scenarios can only be billed once in 7 consecutive days with the total time included in one billing episode for those 7 days.  It appears that Noridian is denying payment for some of these “E visits” and telephonic codes. PLEASE continue to appeal and rebill.

APTA is hoping and they are working hard to convince Medicare to change their policy to include telehealth in our scope of practice.

Keep an eye on UHC. There have been conflicting messages as to what they will pay for via telehealth.

One additional side note—As of April 16, 2020, Tricare
has agreed to recognize PTAs as authorized providers of care.

Telehealth Insurance Guidelines