Guidance for Health Professionals, Athletic Programs, Coaches, Parents & Athletes
The USOPC officially released its return to training and event planning documents. Many AMSSM members have been interested in their content, and we are sharing them in the hopes that they will provide assistance when developing their own plans. Feel free to share these documents with anyone you believe would benefit from their content. The USOPC documents are "living" and will be updated on a regular basis based upon input from experts within AMSSM's membership.
Disclaimer – The resources provided in this section are not official AMSSM Position Statements or endorsed by AMSSM, however multiple AMSSM members were involved in the development of these materials. AMSSM recognizes athletic departments, coaches and athletes are facing a fluid situation with COVID-19 and recommendations/guidance from the CDC, WHO and sporting bodies may be changing regularly as we learn more about this virus. Nonetheless, AMSSM feels there is value in sharing these resources for public consumption and consideration of the membership.
Temporary Expansion of Telehealth Services During the Pandemic Response
As sports medicine physicians continue to react to the worldwide pandemic, AMSSM is tracking ongoing government response efforts that affect you and your practice of sports medicine. The temporary expansion of telehealth services will be a key tool to help you during the pandemic. It not only allows sick and at-risk patients to seek medical care using common technology from home; it also protects you from potential exposure to the virus. In general, AMSSM views these telehealth changes as a necessary response to the national emergency and, if some of these adjustments are made permanent, may change and enhance the way you deliver health care in the future.
We encourage all AMSSM members to establish protocols and procedures for telehealth utilization. The American College of Physicians (ACP) has published coding and billing information at this link. Likewise, the Centers for Medicare and Medicaid Services (CMS) has posted a Medicare Telemedicine Health Care Provider Fact Sheet at this link. CMS has also published a letter to clinicians at this link, with guidance about CMS payments, testing and claims reporting, waivers, and telehealth utilization. CMS recently issued updated guidelines that significantly expand telehealth services, including increased payments for audio-only telephone visits. Please find a brief summary of the relaxed Medicare telehealth regulations below.
CMS published a 20-minute video (to view, click here) that answers common questions about the expanded Medicare telehealth services benefit. For updated CMS information, please visit www.cms.gov/newsroom and the CMS Current Emergencies Website.
A visit with a patient that uses telecommunications systems between a provider and a patient. The relaxed regulations for Medicare Telehealth Visits apply to new or established patients, and to the extent that regulations require an established relationship with a patient, HHS will not conduct audits to ensure that such a prior relationship existed for claims during this public health emergency. Common CPT and HCPCS codes include:
A brief (5-10 minute) check in with a patient via telephone or other telecommunications device to determine whether an office visit or other service is needed. A remote evaluation of recorded video and/or images can be submitted. The relaxed regulations for Virtual Check-Ins apply only to established patients. Virtual Check-In services will usually be initiated by the patient; however, practitioners may need to educate beneficiaries on the availability of the service prior to patient initiation. Common HCPCS codes include:
Communication with a patient through an online patient portal. The relaxed regulations for E-Visits apply only to established patients. For these E-Visits, the patient must generate the initial inquiry and the Medicare coinsurance and deducible apply. Common CPT and HCPCS codes include:
Furthermore, during the public health emergency, CMS is removing requirements regarding documentation of a medical exam or medical history in the medical record and, instead, allowing practitioners to select a level of service for telehealth service based on medical decision making (MDM) or total time spent. This is like the policy that will apply in 2021 under the new physician fee schedule final rule and should prove to be a significant improvement over the 1997 rule.
In addition to CMS guidance, the individual commercial plans are issuing payment rules related to the pandemic response:
Also, the American Medical Association (AMA) has published special coding advice at this link, including different coding scenarios specifically related to COVID-19.
In addition to the temporary relaxation of federal telehealth regulations, several states have adjusted licensure and other requirements for telehealth services. The Federation of State Medical Boards has published a state-by-state chart that may be useful for you to navigate the rules and know what your state license will allow. To view, click here.
AMSSM will publish updates as they become available.
Government COVID-19 Efforts
The federal government is disseminating information to assist small businesses, health care workers, and all Americans through a variety of websites, listed below. Much of this information may be helpful for you or the people you serve. For the most up-to-date information, please see the CDC's website: www.coronavirus.gov.