As the novel coronavirus disease (COVID-19) continues to spread domestically and abroad, the AOA’s top priority remains supporting the needs of DOs and osteopathic medical students.
We have assembled a resource page to help physicians and medical students navigate the global health crisis—whether you are caring for patients as a frontline provider or supporting in other ways.
AOA staff members are continuously updating this page as new information becomes available. Here are some of the latest updates.
CDC to address DOs: At 2 p.m. CT on Thursday, March 26, the CDC will provide an exclusive update on COVID-19 during a live webinar and Q&A. Register here.
FAQ page: We have also added a Frequently Asked Questions page, which seeks to answer questions we’ve received from DOs across the country. Topics include: personal protective equipment (PPE), OMM/OMT, licensing, telemedicine/telehealth, training for students and resident physicians, CME and COVID-19 medical products. Two of the more commonly asked questions from that page are answered below.
Does insurance reimburse for the house visit and OMM/OMT, and what are the codes?
Phone calls and telemedicine visit guidelines have been lifted for services related to COVID-19 or checking on patients. OMT being a manual modality would not be something that can be provided through the audio-visual exchange.
As far as insurers reimbursing for house calls, it varies by each insurer and you would need to check your contract and fee schedule.
Per the AOA Physician Services team, house call codes (99341-99345 for new patients and 99347-99350 for established patients) are found under the Home Services subsection in the Evaluation and Management section. CPT® house call codes are like office visit codes, but with two major differences: The typical face-to-face time is longer with house calls. They may only be billed when services are provided in the beneficiary’s private residence (POS 12). To bill these codes, physicians must be physically present in the beneficiary’s home.
In the case of house calls, physicians need to document that the home visit was medically necessary. In other words, you must present a medical – rather than practical – reason for visiting a patient outside the office. Here are a few other considerations to keep in mind when you bill for a house call:
- Providers need to document if the home visit is based upon a one-time, ongoing or permanent need.
- Documentation should prove that the patient is not physically capable of traveling to the office. You may base this assessment on physical or mental issues but not on financial or personal issues.
- Home services can’t be provided for the physician’s convenience.
- Patients receiving care under Medicare’s home health benefit must be confined to the home. However patients don’t need to be homebound for physicians to provide services billed under CPT codes 99341 through 99350.
The Office of Inspector General (OIG) and many CMS contractors regularly audit home services billed to Medicare. Make sure to provide appropriate documentation showing that the house call was medically necessary.
Please note the CMS recommendations for non-emergent procedures and remember that the OMT codes fall within the surgery section of the CPT book.
I’m a retired physician. I heard we’re being asked to rejoin the workforce. How do I activate my license again to start practicing?
Many states have eased licensing requirements to allow more physicians to help meet the growing healthcare needs of the pandemic. AOA members can send their AOA Profile to all state medical boards at no cost; and non-members only pay a nominal fee. This benefit can enable you to serve in areas of need more quickly through expedited credentialing. Get started at AOAprofiles.org.