Robin 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:
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
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
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
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
TRICARE West - Using Telemedicine, TRICARE East - Telemedicine Policy Updates
One Call Keeps Injured Workers Recovering with Telerehab, One Call: 7 Ways COVID-19 is Impacting Workers' Comp
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.)
Alabama : BCBS Alabama, telehealth fully reimbursed for PT, Tricare East covers continuation of therapy via telemedicine https://www.ptalabama.org/covid-19-updates/%20
Alaska: Per state law, telehealth services for all insurances should be covered when the same care would be covered in-office. https://www.akapta.org/changes-to-coverage-for-telehealth/%20
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
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
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
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
Florida: Cigna: Telehealth permitted for physical therapists, bill CPT 99241 in addition to regular CPT codes (POS 02)
Idaho: Telehealth is permitted by state practice law, but commerical payers decide reimbursement rates. Telehealth State Practice Act
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
Indiana: Telehealth is not permitted for PTs by the state practice act. Telehealth not permitted by state practice act
Kansas: Kansas APTA has posted to links to each payers stance Kansas Payers
Kentucky: Therapists are encouraged to continue providing in-person services to those with emergent or urgent needs In-Person Service Limitations
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
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
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
Missouri: Telehealth has been expanded, but physical therapy has not been included. Telehealth Expansion Does Not Currently Include PT
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
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
Nevada: Telehealth is permitted by state practice act, but commerical payers decide reimbursement rates individually. State Practice Act
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
New Jersey: Fully covered and reimbursed. Full coverage and reimbursement
New Mexico: None
New York: Telehealth is permitted for Medicaid. Medicaid
North Carolina: North Carolina State Practice Act Telehealth is permitted by the state practice act and authorized for Medicaid but not covered.
North Dakota: State Practice ActTelehealth is permitted by the state practice act.
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
Oregon: Lots of information, but it doesn’t look like Oregon is allowing for much with regards to payment. COVID-19 Updates
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
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
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.
South Dakota: None
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
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."
Virginia: Virginia Medicaid Extends Telehealth Services to Early Intervention Providers, Including PTs, OTs, and STs.
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
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.
Wisconsin: Physical Therapy Considered Essential Service Wisconsin APTA is doing a nice job of keeping their members up to date on new information
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.