In the News

Telehealth Home Health Services: New G-Codes

In the CY 2019 HH Prospective Payment System (HH PPS) final rule with comment (83 FR 56406), we finalized the definition of remote patient monitoring in regulations at 42 CFR 409.46(e) as the collection of physiologic data (electrocardiogram, blood pressure, glucose monitoring) digitally stored or transmitted by the patient or caregiver to the HHA.

The first COVID–19 Public Health Emergency (PHE) interim final rule with comment period (IFC) (85 FR 19230) implemented additional policies under the HH PPS to make providing and receiving services via telecommunications technology easier.

The plan of care must describe how such technology is tied to the patient-specific needs in the comprehensive assessment.

The amended plan of care requirements in 42 CFR 409.43(a) also state that these services can’t substitute for a home visit ordered as part of the plan of care. Also, they can’t be considered a home visit for the purposes of patient eligibility or payment, per section 1895(e)(1)(A) and (B) of the Social Security Act. The CY 2021 HH PPS final rule with comment period (85 FR 70298) finalized these changes on a permanent basis. It also amended 42 CFR 409.46(e) to include not only remote patient monitoring, but other communication or monitoring services consistent with the plan of care for the individual, on the HH cost report as allowable administrative costs.

Today, data collection on telecommunications technology use is limited to overall cost data on a broad category of telecommunications services as a part of an HHA’s administrative costs on line 5 of the HHA Medicare cost reports. Data on telecommunications technology use during a 30-day period of care at the patient level isn’t currently collected on the HH claim. While the provision of services provided via a telecommunications system must be in the patient’s plan of care, CMS doesn’t routinely review plans of care to determine the extent these services are actually provided.

Collecting data on telecommunications technology use on HH claims will allow us to:

• Analyze the characteristics of patients using services provided remotely

• Have a broader understanding of the social determinants that affect who benefits most from these services, including what barriers may potentially exist for certain subsets of patients

Starting on or after January 1, 2023, you may voluntarily report the use of telecommunications technology in providing HH services on HH payment claims. We’ll require this information on HH claims starting on July 1, 2023. You’ll submit the use of telecommunications technology on the HH claim using the following 3 G-codes:

• G0320: Home health services furnished using synchronous telemedicine rendered via a real-time two-way audio and video telecommunications system

• G0321: Home health services furnished using synchronous telemedicine rendered via telephone or other real-time interactive audio-only telecommunications system

• G0322: The collection of physiologic data digitally stored and/or transmitted by the patient to the home health agency (for example, remote patient monitoring)

Report the use of remote patient monitoring that spans a number of days as a single line item showing the start date of monitoring and the number of days of monitoring in the units field. You’ll submit services provided via telecommunications technology in line-item detail. Report each service as a separate dated line under the appropriate revenue code for each discipline providing the service. You must document the medical record to show how the telecommunications technology helps to achieve the goals outlined on the plan of care.

You can only report the above 3 G-codes on Type of Bill 032x. You should only report these codes with revenue codes 042x, 043x, 044x, 055x, 056x, and 057x.

Read Full Announcement

 

COVID, Flu, & RSV

Cases of COVID, the flu, and respiratory syncytial virus (RSV) are expected to rise this winter, potentially creating a ‘tripledemic.’ Scientists say the pandemic ‘immunity gap’ is probably behind the surge in viruses. Experts advise Americans to get vaccinated against COVID and the flu to prevent their local hospitals from overflowing. RSV vaccines are currently in development and Pfizer has begun studying a combination vaccine for COVID and the flu.

  • COVID-19: Coronavirus-related hospitalizations are rising and at least half a dozen Omicron subvariants are competing to be the next dominant strain in the US. New data from Pfizer suggests that the updated booster provides four times stronger protection against more recent Omicron variants than the original vaccine. 
  • The Flu: So far, this flu season has been earlier and more severe than it has been in 13 years, according to data from the Centers for Disease Control and Prevention (CDC). Inequities have been found in flu vaccine uptake. Black, Hispanic, and Indigenous adults are more likely to be hospitalized with the flu and less likely to be vaccinated against it.
  • RSV: RSV is a common respiratory virus that can be serious for young children and older adults. Children’s hospitals are being overwhelmed by the nationwide surge in RSV cases. The unusually early and drastic spike in RSV cases has increased wait times and is straining health care resources.
 

VA Support for Family Caregivers

November is National Family Caregivers Month. In the words of former first lady and caregiver advocate, Rosalynn Carter, “There are only four kinds of people in the world: those who have been caregivers, those who are currently caregivers, those who will be caregivers, and those who will need caregivers."

What Can I Do?

One place to start is with a Caregiver Self-Assessment. Complete the assessment to see what services or supports you may need. VA provides support and resources to family caregivers, including:

Learn about Services and Supports for Veterans

Many services offered by VA may benefit Veterans and family caregivers. All services are based on Veterans’ eligibility, clinical need for the service and service availability.

Other VA and non-VA Resources

 

 

Live Webinar | The CY2023 Home Health Final Rule: Leading Your Agency Through Change

Wednesday, November 16 | 11:00am - 12:00pm MT

Presented by Cindy Campbell, MHA-Healthcare Informatics, BSN, RN, COQS, CHHCM, Director of Operational Consulting, WellSky

Register for the Webinar

 

President's Message

Posted: November 1, 2022

As many of you already know, the 2023 Final Rule was published yesterday. Through extensive advocacy by APTA Home Health, APTA, and many others, we have staved off the full extent of the “behavioral adjustment”. We must continue our advocacy efforts, however, to ensure the sustainability of our industry going forward. Legislation is needed to prevent these unfounded “behavioral adjustments,” and force CMS to utilize a data-driven process to set rates.

If you have not yet completed the member survey that you received about 2 weeks ago, please complete it now! It is vitally important to us to know what you perceive as valuable so we can maximize your experience as an Academy member. Thank you in advance for taking five minutes of your time to let us know your wants and needs from APTA Home Health.

Sincerely,

Phil Goldsmith
President
APTA Home Health

 
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