CMS Expands Telehealth Coverage for Opioid Abuse Disorder Treatment

November 2019 ~

In the final 2020 Physician Fee Schedule, CMS has added three CPT codes for telehealth services included in bundled episodes of care for opioid abuse treatment, including care delivered to the home.

The new codes were first proposed in July when CMS recommended creating new bundled episodes of care for treatment of opioid use disorders and adding three CPT codes for care management and counseling that could include connected health services.

The three new codes 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.

The codes are listed in the rule under the Communication Technology-Based Services category. These codes are as follows:

  • 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).

In addition to the new codes, CMS also clarified a potentially cumbersome requirement for patient consent. Under the final rule, care providers will only need to obtain one consent (including co-pay) each year from the patient for multiple services or interprofessional consultations, rather than consent for each individual service.

CPT® is a registered trademark of the American Medical Association.
Source(s): mHealth Intelligence; Policy & Medicine; American College of Radiology;

 

 

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