Daily COVID-19 Email Update - March 13, 2020

A Message from Dr. Rebecca Wartman, NCOS Third Party Liaison

During this public health emergency from the COVID-19 virus outbreak, Congress has passed emergency funding legislation that will allow the Department of Health and Human Services (DHHS) to make changes to non-face to face service rules. The CPT® Book lists four different types of non-face to face services: telehealth services, virtual check-in services, e-services, and telephone services. While the emergency funding bill just passed and was signed into law, to date, there has been NO changes to the CMS rules for using any of the non-face to face service codes. Stay tuned for any future changes as CMS is in the process of evaluating the current rules.

As it currently stands, optometry has access to virtual check-in, e-services and telephone services for Medicare patients and, perhaps, some private insurers. However, under the current NC Medicaid rules, we cannot bill any of these services for Medicaid patients. Currently, Medicare does not cover telephone services (99441-99443) at this time, but it may be covered by some private insurance. Generally, due to the current rules, very few optometrists can utilize telehealth services. Here is a quick review for all the non-face to face services
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The NC DHHS and NC Medicaid are reviewing all the current rules and trying to ensure that patients can have access to proper and safe care during this public health emergency. However, as previously stated, the rules remain the same: an optometrist, as a non-physician ancillary provider under state law, cannot provide any of the non-face to face services to Medicaid patients. 

There is one change you do need to be aware of for NC Medicaid: the NC DHHS are relaxed on pharmacy rules. At this time, they will allow a 90 day supply of any medication including new medications that are non-controlled substances and can be either generic or branded medications. Please ensure you write prescriptions for 90 day supplies of medications for non-controlled substances whether generic or branded medications, preferred or non-preferred formulary medications. 

The AOA has published guidance from the AOA Health Policy Institute for your use. Please see the policy brief by clicking here. Remember to maintain universal precautions in your practice to protect you, your staff and all your patients. The CDC has a recommended questionnaire that should be used for both staff and patients entering your practice. 

There will be a webinar presentation on Tuesday March 17, 2020 at 9:00 PM EDT on the topic of non-face to face service coding. This will include any new information and updates that are available at that time. The AOA and NCOS are working hard to ensure accurate updated information is provided. 

Most important: If you or any of your staff have any symptoms of COVID-19 or other illness, please stay at home and away from the public and your patients. Call your own medical provider if you are concerned you may have contracted this virus and do all you can to stay healthy.