The Centers for Medicare & Medicaid Services will have new reimbursement codes for care providers who utilize telehealth to treat opioid abuse patients. As part of the 2020 Physician Fee Schedule, CMS is adding three CPT codes that will allow providers to bill Medicare for telehealth services included in bundled episodes of care for opioid abuse treatment, including care delivered to the home.
These codes were first proposed in July to apply connected health technology to the ongoing opioid abuse epidemic.
CMS Administrator Seema Verma mentioned in a July press release announcing the proposed codes. She said that proposals were being announced so that the government doesn’t come in the way of patient care, by giving clinicians the support they need to spend valuable time taking care of these patients to ensure their diseases were well-managed and their quality of life is preserved.
Now included in this newly announced final rule in a category titled Communication Technology-Based Services, the codes are:
HCPCS code G2086, covering at least 70 minutes during the first calendar month of office-based treatment for opioid use disorder, including development of the treatment plan, care coordination, individual therapy and group therapy and counseling;
HCPCS code G2087, covering at least 60 minutes in a subsequent calendar month of office-based treatment for opioid use disorder, including care coordination, individual therapy and group therapy and counseling; and.
HCPCS code G2088, covering each additional 30 minutes beyond the first two hours of office-based treatment for opioid use disorder, including care coordination, individual therapy and group therapy and counseling (filed alongside the code for a primary procedure).
An analysis of the new codes penned by Nathaniel Lacktman, a partner in the Foley & Lardner law firm and chair of its national Telemedicine & Digital Health Industry Team, and Emily Wein, a healthcare lawyer with the firm, the new codes combine with recent legislation to give new opportunities to deliver care to the patient’s home.
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