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E-Visits: WebPT EMR

As of March 17, 2020, CMS will reimburse PTs, OTs, and SLPs for E-Visits provided during the COVID-19 response for services occurring on or after March 6, 2020. 

What is an E-Visit?

CMS describes an e-visit as “non-face-to face…patient-initiated digital communications that require a clinical decision that otherwise typically would have been provided in the office.” Check out this E-Visit FAQ for a complete breakdown of e-visits. 

E-Visit Workflow

  1. The clinic notifies established patients that they are offering e-visits.
  2. An existing patient reaches out and requests service. This should occur through a secure online patient portal (i.e., WebPT’s HEP and Patient Portal). Alternatively, given the loosening of HIPAA penalties during the COVID-19 response, you can use telephone, email, or even Facetime/Skype—although the APTA still recommends using a HIPAA-compliant platform. 
  3. The provider responds to the patient through the communicated contact method and receives patient consent to participate in an e-visit.  
  4. The provider delivers e-visit assessment and management services to the patient and documents services/tracks time spent over a seven-day period (starting when the provider responds to the patient’s request) in a daily note. Tracked time should include time spent interacting with the patient and on clinic decision-making to update plans and provide guidance. 
  5. At the conclusion of the seven-day period, the time should be totaled and the appropriate code billed. Then, you can finalize the daily note. 

How Do I Use the WebPT EMR to Manage E-Visits?

Set a Place of Service

The place of service for e-visits is your current location. If you are completing these e-visits from your clinic location, use 11 - Office. If you are conducting these e-visits from your home, use the 12 - Home place of service. Remember, you can set a place of service from the patient’s case or for individual notes. 

Important: Because e-visits are not considered telehealth by CMS, the 02-Telehealth place of service should not be billed for these visits. 

What Should I Document? 

  1. Start a note for the patient after responding to their initial contact.
  2. Document that the patient initiated the service and how the patient initiated the service (if possible). Additionally, include the reason why the patient is unable to attend the visit in person.
  3. Document each interaction for the next seven-day period within this note. 
  4. Track the time you spend communicating with the patient, and the time you spend gathering information and using your clinical decision-making abilities to distill it into guidance for the patient.  

Complete the Billing Sheet

At the end of the seven-day period, add up the total amount of time you spent on the e-visit. Then select the appropriate code based on the time you calculated. Important: Do not bill any other codes. 

Medicare

The following codes are available in the Untimed Codes section. Remember, Medicare payers will only accept the following codes: 

  • 98970: Qualified non-physician healthcare professional online assessment and management, for an established patient, for up to seven days, cumulative time during the 7 days; 5–10 minutes
  • 98971: Qualified non-physician healthcare professional online assessment and management service, for an established patient, for up to seven days, cumulative time during the 7 days; 11–20 minutes
  • 98972: Qualified non-physician qualified healthcare professional assessment and management service, for an established patient, for up to seven days, cumulative time during the 7 days; 21 or more minutes.

You must use the 95 modifier on these codes to ensure they are accepted by Medicare. To add the 95 modifier, use the steps described here

Total Treatment Time

In order to comply with the 8-Minute Rule, ensure that you have 0 entered for Total Direct Minutes and the time you are charging for in the Total Treatment Minutes box. 

Don’t see the codes? 

Check your Company Fee Schedule and ensure the codes are checked.

What if My Patient's Plan of Care is Expired?

Because CMS has indicated that e-visits do not count towards the patient's plan of care, we've built the following option in the WebPT EMR that allows you to document e-visits outside of the plan of care dates.

Select the Document E-Visit button when starting the note. This will open a Daily Note, allowing you to complete the patient's e-visit documentation without updating the plan of care. 

Billing Integrations

RevFlow/WebPT Billing

  • The CR modifier will import automatically with no additional action required on your part. 
  •  You must send an email to updates@webpt.com containing the price you want to charge for each of the Medicare codes you plan to use. This will allow us to update your RevFlow/WebPT Billing Procedure Codes list. 
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