Note: this post has been updated since initial publication (4/3/2020) to reflect recent changes to CMS billing.
Mark N. Painter, CPMA, presented “Billing and Regulations for Telehealth During COVID-19” for the Grand Rounds in Urology audience in March, 2020.
How to cite: Painter, Mark N. “Billing and Regulations for Telehealth During COVID-19” March, 2020. Accessed Nov 2024. https://dev.grandroundsinurology.com/billing-and-regulations-for-telehealth-during-covid-19/
UPDATED – Billing and Regulations for Telehealth During COVID-19 – Summary:
Mark N. Painter, CPMA, managing partner of PRS Consulting, LLC, CEO of PRS Urology Service Corporation and the Vice President of Coding and Reimbursement Information for Physician Reimbursement Systems, Inc. (PRS), and CEO of Relative Value Studies, Inc., gives an in-depth guide for how to bill for telehealth visits as they increase during the COVID-19 crisis. He gives background information on current telehealth and telemedicine regulations and billing, including CMS (Medicare & Medicaid), as well as detailing temporary changes to the Stafford Act that have been enacted during the current coronavirus pandemic to accommodate the increased number of remote visits. Mr. Painter further details relevant billing codes and requirements for getting them approved, circumstances where co-pays may be waived, as well as requirements for treating new patients. He also covers the current situation and possible changes to multi-state practitioning as it relates to distance treatment.
For other urology-focused information on the COVID-19 pandemic, visit our resource page.
ABOUT THE AUTHOR
Mark N. Painter is a managing partner of PRS Consulting LLC, the CEO of PRS Urology Service Corporation, the Vice President of Coding and Reimbursement Information for Physician Reimbursement Systems, Inc., and CEO of Relative Value Studies, Inc. Since co-founding PRS in 1989, Mr. Painter has served as the primary coding resource for the PRS products currently produced and marketed in conjunction with 9 National Specialty Organizations including hotlines, coding manuals, and quick reference tools, the internet-based application codingtoday.com, and seminars. He has lectured to a variety of groups concerned with healthcare reimbursement. Mr. Painter’s extensive knowledge of physician documentation, as well as coding and reimbursement issues, has allowed him to assist insurance companies, physicians and their staff members, legal counsel, actuaries, specialty societies, consultants, and the medical industry on a daily basis. Mr. Painter has been the lead for the company on multiple corporate/physician integrity agreements serving as the Independent Review Organization (IRO), and has successfully overseen the review and continued participation in Medicare of several practices from multiple specialties. Mr. Painter has been commended for his education and direction for appropriate documentation and coding by multiple Medicare medical directors with whom he has shared the podium during national and regional medical meetings. He serves as an expert in legal counsel for bio device companies, medical directors, and pharmaceuticals.
