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Telehealth 101 – Patient Eligibility and Consent

All patients are eligible for telehealth and it is important to get patient consent prior to virtual visit and make sure to follow HIPAA standards for all remote interactions.

Download Humana’s Telehealth Playbook, PDF opens new window

What patient can use telehealth?

All patients are eligible. Patients are no longer required to have an established relationship with the telehealth provider in order to have a telehealth visit.

Additionally, CMS now permits all health care professionals that are eligible to bill Medicare for professional services to perform telehealth services.

Urgent Care facilities follow the same requirements and billing procedures as private practices using the 95 modifier.

Skilled nursing facilities (SNF) and nursing homes can bill telehealth services by having the providers as the billing entity. The visit codes generally billed by nursing home providers can now be billed via telehealth using the -95 modifier.

As a response to COVID-19, there are no limits to how often a SNF can bill for telehealth.

What do I need to know about patient consent?

It is required by all states that a patient affirmatively consent to a telehealth encounter.

A reminder, when a patient lives out of state and you are offering a telehealth visit, the patient should be notified if you are not licensed to practice in that state and obtain consent. It is also recommended that this be documented in the EHR.

Do I need a Business Associate Agreement (BAA)? What do I need to know about HIPAA?

On March 17, 2020, the Office of Civil Rights (OCR) within the Department of Health and Human Services (HHS) announced that it will not conduct enforcement action or impose penalties against providers who, in good faith, provide telehealth services during the COVID-19 nationwide public health emergency.

Therefore, during the public health emergency, providers can use commercially available audio and/or video communication technology to provide telehealth encounters to patients.

If your selected telehealth platform records the telehealth encounter, that recording must be treated as PHI.

The platform that you choose cannot be public facing.

This is limited relief from federal privacy regulations during this time of a national health emergency only.