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Tools for Your Hospice Tool Box: Telehealth Flowchart for Billable Hospice Physician and Nurse Practitioner Services During the COVID-19 Pandemic

By Meg S.L. Pekarske & Andrew Brenton on April 8, 2020
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The Centers for Medicare and Medicaid Services (“CMS”) confirmed that hospice physicians and nurse practitioners who serve as a patient’s attending physician (“NPs”) can use telehealth to perform medically necessary visits during the COVID-19 pandemic. To assist hospices in evaluating the feasibility of using telehealth for medically necessary visits with Medicare patients, Husch Blackwell has created a “Hospice Telehealth Flowchart.” The Flowchart addresses important operational considerations as well as the Medicare requirements related to rendering and billing for such telehealth visits.

CMS’s pronouncement that Medicare will pay for medically necessary hospice physician and NP telehealth visits does not change what hospice physician and NP services are billable, but rather clarifies that such services now can be performed via audio and visual, two-way, real-time telehealth technologies. Pursuant to 42 C.F.R. § 418.304, only non-administrative, direct patient care services provided by a hospice physician or NP may be billed to Medicare, and only when:  (i) the services are reasonable and medically necessary for the palliation and management of a Medicare hospice patient’s terminal prognosis or related conditions and (ii) the physician or NP is employed by or under arrangement with the hospice (“Billable Physician/NP Visit”).

Husch Blackwell’s “Hospice Telehealth Flowchart” outlines, in a step-by-step format, the specific Medicare requirements and some operational best practices for hospices that are considering using telehealth to perform Billable Physician/NP Visits with Medicare hospice patients during the COVID-19 pandemic. The Flowchart can assist hospices in assessing whether telehealth Billable Physician/NP Visits are viable from a business and clinical perspective, and if so, for which hospice patients telehealth visits may be appropriate and feasible.

The Husch Blackwell Hospice Team are problem-solvers, and we are here to provide you with support, guidance, ideas, and strategies in the face of this unprecedented pandemic. If you are having challenges with facility access issues or any other issue related to the coronavirus, please let us advocate for you, develop materials to help you trouble-shoot, or otherwise be of assistance to you. We are here to serve.

Photo of Meg S.L. Pekarske Meg S.L. Pekarske

Meg has devoted her legal practice to serving the everchanging legal needs of the hospice industry. As chair of Husch Blackwell’s Hospice and Palliative Care Practice Group, she manages the firm’s hospice practice. In working day in and day out with hospice clients …

Meg has devoted her legal practice to serving the everchanging legal needs of the hospice industry. As chair of Husch Blackwell’s Hospice and Palliative Care Practice Group, she manages the firm’s hospice practice. In working day in and day out with hospice clients across the country, Meg is intimately familiar with the operational challenges of hospices and has the experience to address the full spectrum of legal issues facing the industry, from routine regulatory compliance issues to multimillion dollar Zone Program Integrity Contractor (ZPIC), Medicaid and other government audits. Additionally, Meg routinely advises hospices on palliative care program development, innovative inpatient unit structures, fraud investigations and a wide range of contracting issues. With an extensive background in long-term care, Meg brings a unique perspective and skill set to helping hospices create successful partnerships with nursing homes and assisted living facilities and providing quality end-of-life care to patients.

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Photo of Andrew Brenton Andrew Brenton

Andrew is part of the firm’s coast-to-coast Hospice & Palliative Care Team, working with clients on a broad range of regulatory concerns, from compliance to business growth. He answers questions that might otherwise keep clients awake at night. Andrew and the team…

Andrew is part of the firm’s coast-to-coast Hospice & Palliative Care Team, working with clients on a broad range of regulatory concerns, from compliance to business growth. He answers questions that might otherwise keep clients awake at night. Andrew and the team also help navigate clients through a wide range of Medicare and Medicaid audits, fraud and repayment investigations, and contracting issues.

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  • Posted in:
    Featured Posts, Health Care
  • Blog:
    Healthcare Law Insights
  • Organization:
    Husch Blackwell LLP
  • Article: View Original Source

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