Telecommunications Reporting Requirements Begin July 1 for Home Health Agencies

Digital patient care grew enormously in use and popularity during the COVID-19 pandemic, and CMS has recognized its ongoing significance and value for home health agencies by allowing them to continue to receive reimbursement for telecommunications services, a category of digital care that includes telehealth.

This benefit will continue permanently beyond the Public Health Emergency (PHE), which ended on May 11, 2023. But to take advantage of it, agencies must begin reporting any use of telecommunications technology on home health claims beginning on July 1, 2023. In this article, we’ll take a closer look at this benefit and how to fulfill the claims requirements.

Recognizing the Value of Digital Care for Home Health

On October 29, 2020, CMS permanently authorized the use of telecommunications technology as part of patient care in a home health setting via the Home Health Prospective Payment System Final Rule. This was an important regulatory step toward CMS recognizing the increasingly critical role of digital care for home health beyond the COVID-19 pandemic.

Now, beginning on July 1, 2023, agencies will be required to report new telecommunications G-codes for 30-day periods of care that start on or after July 1. Previously, data reporting on telecommunications technology use was limited to the overall costs of a broader category of telecommunications services on Medicare cost reports and did not include 30-day periods of care at the patient level on home health claims.

According to CMS, collecting this type of telecommunication services data will help provide insight into the characteristics of patients using virtual care, the social determinants influencing who benefits most from it, and any barriers that might exist for patients.

How CMS Defines Telecommunications Technology

CMS defines telecommunications as including remote patient monitoring of physiologic data, telephone calls (audio only and TTY), and two-way audio-video technology that allows for real-time interaction between the clinician and patient (such as telehealth). Agencies may use telecommunications technology under the following conditions:

• The telecommunication services are not a substitute for a home visit ordered as part of the plan of care.
• The telecommunication services are not intended to establish patient eligibility or payment.
• The telecommunications modality is included in the plan of care.
• The telecommunication services, including remote patient monitoring, are deployed to address patient-specific needs as identified in the comprehensive assessment.
• The medical record describes how the telecommunication services will help facilitate treatment outcomes/goals identified in the plan of care.

Using the New G-Codes

The 2023 final rule includes instructions for reporting telecommunication services on home health claims with new G-codes. These codes are:

G0320—Home health services furnished via a real-time, two-way audio and video telecommunication system.
G0321—Home health services furnished via a telephone or other real-time interactive audio-only telecommunication system.
G0322—Collections of physiologic data digitally stored and/or transmitted by the patient to the HHA (i.e., remote patient monitoring).

Primary reporting requirements:

• The G-codes should only be reported with revenue codes 042x, 043x, 044x, 055x, 056x, and 057x.
• G0320 and G0321 will be reported on claims as separate dated lines with the appropriate revenue code for each discipline.
• G0322 remote patient monitoring will be reported on claims as a single line item, with the number of days of monitoring in the units field.

Future-Proof Your Agency with MedBridge

As the healthcare industry evolves toward digital care, more home health agencies are adopting it as a way to improve patient engagement and outcomes—and studies show that patients want this type of care.¹ The comprehensive MedBridge Home Health Care Solution includes the digital care tools your agency needs to keep patients engaged between in-home visits, better manage chronic conditions, reduce ED and acute care utilization, and improve patient and family satisfaction.

References

1. KLAS Research, Patient Perspectives on Patient Engagement Technology.