We encourage members to review insurance coding announcements from your various insurances on any coding changes for audio-only telehealth services. For instance, MVP has just announced Modifier V3 and Place of Service (POS) code 99 (“other”) for plain old telephone therapy, effective January 1st. We recommend taking a look directly at your insurance announcements on this topic for definitive information, or the MVP payment manual here (PDF page 21).
Our Insurance Chair, Milton Marasch, has drawn our attention to some changes to CMS place of service codes. According to at least one source, CMS looks like they will be requiring one in-person visit within 6 months of the initial tele-mental health service, and then again at least once every 12 months, with some exceptions available for the latter. APA services also reviews CMS and Medicare telehealth in 2022 here.
From Dr. Milt Marasch, VPA Insurance Chair:
Here’s an FYI for folks. I just ran across a 2016 web article from the APA on problems with coding updates for the DSM-5. Apparently some of the DSM codes did not crosswalk well to the ICD-10 codes as printed in the DSM-5 manual.
Here’s the APA article:
And here’s the direct link to the ApA (psychiatry) PDF with changes/corrections:
https://psychiatryonline.org/pb/assets/raw/dsm/pdf/DSM-5%20Coding%20Update_Final.pdf
<https://psychiatryonline.org/pb/assets/raw/dsm/pdf/DSM-5%20Coding%20Update_Final.pdf>
You may have received a 1099 for the Provider Relief Payment you received in 2020, and you may be asking whether that payment is taxable. Normally when you receive a Form 1099 for income, that income is taxable, but because VPA is not able to provide legal or tax advice, we recommend you speak to the IRS helpline, your accountant or tax expert about the issue.
You can see some additional information on here.
Cotiviti is the record retrieval contractor for VT Medicaid and has begun outreaching selected providers to request the submission of medical records in support of VT Medicaid’s Medical Record Review (MRR). Cotiviti will call each provider to confirm they have reached the correct office before faxing a record request letter and a member request form or a member list with the names of the Medicaid members for whom they are requesting records. The cover letter will be on VT Medicaid letterhead. Please pay close attention to the HEDIS Measure Requirements and Date of Service fields and only submit the type of record requested within the stated timeframe. For more info visit https://dvha.vermont.gov/providers/audits/hedis-hybrid-measure-medical-record-review-mrr.