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  • Writer's pictureRobin R Varghese, PT.

Telehealth Reimbursements for PT/OT/SLPs as of today (March 27th, 2020) due to COVID19 Pandemic.

Please remember that these are approved only for a certain period for each insurances and kindly check with each one of them to see for what DOS these are covered. Most of them are during the National Emergency Declaration period, some are for March 20-April 30th, 2020 only.

General information for each Insurance carriers are listed first:

  1. Aetna Aetna Opens E-Visit Coverage to PTs Aetna's approach to billing e-visits is slightly different from Medicare's. Providers should log in to their Aetna Provider account for specific information on how to bill. Aetna's COVID-19 Resources for Providers

  2. Cigna Cigna Expands Telehealth coverage to Outpatient Rehab. Cigna paying for PT/OT/SLP Telehealth Services for specified codes through May 31st, 2020. Requires GQ Modifier and POS 11. Cigna COVID-19 Billing Guidance

  3. Medicare Medicare Introduces E-Visit Coverage. At this point, Medicare is only covering e-visits on the federal level. Please see our eVisit page for more info. CMS - Medicare Telemedicine Provider Fact Sheet, Medicare Telehealth FAQs

  4. UHC UHC Announces Telehealth Coverage. UHC paying for PT/OT/SLP Telehealth Services through June 18th, 2020. Requires 95 Modifier and POS 02. United HealthCare - PT, OT and Speech Telehealth

  5. TriWest Healthcare Alliance COVID-19 Resources & Telehealth

  6. Humana COVID-19 Telemedicine

  7. TRICARE West - Using Telemedicine, TRICARE East - Telemedicine Policy Updates

  8. One Call Keeps Injured Workers Recovering with Telerehab, One Call: 7 Ways COVID-19 is Impacting Workers' Comp

  9. Medrisk Expands Telerehab Services

State specific Information(If the insurance carriers have agreed to cover on a national basis as the ones listed above, they should cover each state specific Telehealth services as well.)

  1. Alabama : BCBS Alabama, telehealth fully reimbursed for PT, Tricare East covers continuation of therapy via telemedicine

  2. Alaska: Per state law, telehealth services for all insurances should be covered when the same care would be covered in-office.

  3. Arizona: Per Executive Order points 3 and 6, telemedicine is permitted for PTs and reimbursed fully at the same rate as in-person services. Executive Order

  4. Arkansas: None

  5. California:By order of California Emergency Services Act, all telehealth services are to be reimbursed at the same rate as in-person services provided that "if the service is the same regardless of the modality of delivery." Telehealth Coverage, Per Executive Order

  6. Colorado: Colorado Medicaid has expanded coverage to include telehealth coverage for PTs. Carrier specific information is available from the Colorado chapter of the APTA Colorado Medicaid, Payer Specific Information

  7. Connecticut: Telehealth coverage for Medicaid patients requiring physical therapy has been expanded and the Connecticut APTA is currently advocating for the governor to expand care further. Medicaid

  8. Delware: None

  9. Florida: Cigna: Telehealth permitted for physical therapists, bill CPT 99241 in addition to regular CPT codes (POS 02)

  10. Georgia: None

  11. Hawaii: None

  12. Idaho: Telehealth is permitted by state practice law, but commerical payers decide reimbursement rates. Telehealth State Practice Act

  13. Illinois: Per executive order: "Telehealth Services subject to this Executive Order’s coverage requirements may be provided by any in-network physicians, physician assistants… occupational therapists, physical therapists, speech-language pathologists… as long as they are licensed, registered, certified, or authorized to practice in the State of Illinois, regardless of whether or not the in-network provider was originally established prior to the COVID-19 pandemic in any designated telehealth network for the policy, contract, or certificate of health insurance coverage." Executive Order

  14. Indiana: Telehealth is not permitted for PTs by the state practice act. Telehealth not permitted by state practice act

  15. Iowa: None

  16. Kansas: Kansas APTA has posted to links to each payers stance Kansas Payers

  17. Kentucky: Therapists are encouraged to continue providing in-person services to those with emergent or urgent needs In-Person Service Limitations

  18. Louisiana: None

  19. Maine: None

  20. Maryland: State practice act permits telehealth for outpatient rehab. The Maryland APTA chapter has a homepage where they are announcing changes to coverage as they become available. State Practice Act

  21. Massachusetts: From president of chapter: "The follow up Bulletin 2020-04 from the Division of Insurance confirms that provision of physical therapy services is included in the telehealth order. Services are to be provided in a manner consistent with current clinical practice. This includes maintenance of HIPAA compliance, billing and coding regulations, etc." Bulletin 2020-04

  22. Michigan: Per the Michigan Physical Therapy Association: "Private payer updates on coverage for telehealth services: BCBSM just notified MPTA it will cover CPT Codes 97110, 97112, 97116, 97530 and 97535 via telehealth effective for both commercial and MA population until June 30.” Michigan Physical Therapy Association

  23. Minnesota: None

  24. Mississippi: None

  25. Missouri: Telehealth has been expanded, but physical therapy has not been included. Telehealth Expansion Does Not Currently Include PT

  26. Montana: According to APTA chapter vice president, Christian Appel, telehealth is being covered by most commerical payers, including BCBS and Pacific Source BCBS and Pacific Source

  27. Nebraska: "The Nebraska Chapter is working with insurance companies to relax or eliminate policies that make it difficult for the community to access our services. Currently Medicare does not reimburse physical therapy for telehealth but will for e-visits. Blue Cross and Blue Shield today stated that they will not pay physical therapists for telehealth but the Nebraska Chapter will continue to advocate for this." Nebraska APTA Statement

  28. Nevada: Telehealth is permitted by state practice act, but commerical payers decide reimbursement rates individually. State Practice Act

  29. New Hampshire: Per executive order, telehealth is permitted for physical therapy and reimbursement should be equal to in-person. However, individual payers will determine acceptable codes, modifiers, and POS. Executive Order

  30. New Jersey: Fully covered and reimbursed. Full coverage and reimbursement

  31. New Mexico: None

  32. New York: Telehealth is permitted for Medicaid. Medicaid

  33. North Carolina: North Carolina State Practice Act Telehealth is permitted by the state practice act and authorized for Medicaid but not covered.

  34. North Dakota: State Practice ActTelehealth is permitted by the state practice act.

  35. Ohio: PTs Evaluation Codes and Therapeutic Activities are specifically mentioned here as being covered through Ohio Medicaid Telehealth.Ohio Medicaid Special Considerations for COVID-19 EmergencyOhio Medicaid landing page for changes related to their emergency declaration Ohio Medicaid Services Reimbursed Through Telehealth During a State of Emergency

  36. Oklahoma: None

  37. Oregon: Lots of information, but it doesn’t look like Oregon is allowing for much with regards to payment. COVID-19 Updates

  38. Pennsylvania: Specific payer by payer information on what is being reimbursed. Medicaid (Children only), Humana, Aetna, and Geisinger Health Plan all covering E-Visits.March 24, 2020 - Payer Updates, PPTA COVID-19 Updates and Resources

  39. Rhode Island: Rhode IslandNeighborhood Health Plan of RI Temporary COVID-19 Telemedicine Services Payment PolicyAllows for payment on Telehealth services provided by PTs / OTs / STs Rhode IslandBCBS Payment Policy Update on Telehealth during COVID-19Allows for payment on Telehealth services provided by PTs / OTs / STs

  40. South Carolina: Guidance Regarding Use of Telehealth to Provide Physical Therapy Services During Public Health State of EmergencyIndicates PTs can provide Telehealth. Nothing Payer specific.

  41. South Dakota: None

  42. Tennessee: APTA TN - Update on Essential & Nonessential Providers Telehealth or TeleRehab & Evisits Theyre providing regular updates, but no confirmation of payment for telerehab from any payer. They are focusing in on BCBS

  43. Texas: None

  44. Utah: Coronavirus landing page for UPTAIndicates "Utah contains open language in state regulation or reimbursement policies that may allow for Medicaid to reimburse for telerehab services."

  45. Vermont: None

  46. Virginia: Virginia Medicaid Extends Telehealth Services to Early Intervention Providers, Including PTs, OTs, and STs.

  47. Washington: A Guide to Providing Treatment via Telehealth for PTs and PTAs in Washington Washington HCA Offers Limited Number of No-Cost Telehealth Technology Licenses for Providers

  48. West Virginia: COVID-19 Message from WVPTA Board of Directors Suggests E-Visits through CMS, or telehealth through "WV BMS" which is their Medicaid provider. No additional details.

  49. Wisconsin: Physical Therapy Considered Essential Service Wisconsin APTA is doing a nice job of keeping their members up to date on new information

  50. Wyoming: None

Sourced from APTA, Theraoffice, State specific PT board websites.

Disclaimer: We do not endorse Telehealth for PT/OT/SLP services in current format or CPT codes and believes that without adequate precautions and oversight, telehealth could reduce Therapist Job openings, could take work away from Local therapists, leverage Insurance carriers more against us in our professional and autonomous abilities, more than all- could reduce reimbursement further and could lead to more digital and virtual therapists! The information is provided here only to help those increasing number of therapists looking for further information regarding Telehealth.

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