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COVID-19: Frequently Asked Questions

Below are some of the most frequently asked questions CMA has received during the COVID-19 outbreak. By default, the most recent answers will appear up top. You can also filter the FAQ by category. We will update this resource regularly.

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Archive by category: Hospital and Medical StaffReturn
Specific policies and procedures for implementing telehealth in the in-patient setting should be developed by the medical staff. Under the declared state of emergency, the requirements for hospitals to credential and privilege physicians, including distant-site telehealth providers, have been temporarily waived. However, individual medical staffs should determine whether it is appropriate to suspend credentialing and privileging requirements, and, if so, to consider implementation of alternate m...
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| Categories: Hospital and Medical Staff, Telehealth
No. Services should only be reported as telehealth services when the physician furnishing the service is not at the same location as the patient. If the patient and the physician are in the same institutional setting but are utilizing telecommunications technology to furnish the service due to exposure risks, the physician would not need to report this service as telehealth and should instead report whatever code described the in-person service furnished.
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| Categories: Hospital and Medical Staff, Telehealth
For Medicare, the physician should report the place of service (POS) code that would have been reported had the service been furnished in person. Modifier 95 should be applied to claim lines that describe services furnished via telehealth. These billing changes only apply to professional fees, and there are no changes to institutional or facility fees.For Medi-Cal fee-for-service, Medi-Cal managed care and plans licensed by the Department of Managed Health Care (DMHC), physicians should bill usi...
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| Categories: Hospital and Medical Staff, Telehealth
Telehealth services are not limited by specialty. It is the role of the medical staff, in consultation with specific departments, to determine if services are appropriate to be delivered via the telehealth modality. While the Centers for Medicare and Medicaid Services (CMS) has issued several temporary waivers and new rules to allow health care providers maximum flexibilities to respond to the COVID-19 crisis, physicians and medical staffs should be aware of the unique standard of care issues th...
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| Categories: Hospital and Medical Staff, Telehealth
Under a blanket waiver issued by the Centers for Medicare and Medicaid Services (CMS), Medicare will pay for hospital visits furnished via telehealth on an expanded basis. Previously, Medicare payment for telehealth was limited to designated rural areas and had limits on originating and distant sites. These limitations do not currently apply. Additionally, HHS will not conduct audits to ensure that such a prior relationship existed for claims submitted during the public health emergency. Current...
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| Categories: Hospital and Medical Staff, Telehealth
In general, yes. Telehealth providers must still meet the definition of “health care provider” as set forth in Cal. Bus. & Prof. Code § 2290.5(3)(A), which requires California licensure. However, during the COVID-19 emergency, the Emergency Medical Services Authority (EMSA) has established an expedited process for hospitals and telehealth agencies to obtain approval to use physicians licensed in other states. EMSA will only accept requests for out-of-state medical personnel ...
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| Categories: Hospital and Medical Staff, Telehealth
In general, Medicare conditions of participation require a hospital to have an organized medical staff that is responsible for credentialing all members of the medical staff. When telehealth services are provided to a hospital’s patients by a distant-site hospital or telemedicine entity, the governing body of the hospital, instead of requiring the normal credentialing process, may allow its medical staff to rely on privileging decisions made by the distant site entity, provided that there ...
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| Categories: Hospital and Medical Staff, Telehealth
The Equal Employment Opportunity Commission (EEOC) recently issued guidance that employers may administer a COVID-19 test (a test to detect the presence of the COVID-19 virus) to employees prior to entering the workplace.
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| Categories: Hospital and Medical Staff, Labor and Personnel, Testing
Section 1861(i) of the Social Security Act permits Medicare payment for Skilled Nursing Facility (SNF) care only when a beneficiary first has an inpatient hospital stay of at least three consecutive days.
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| Categories: Hospital and Medical Staff
CMS is waiving the provisions related to telemedicine at 42 CFR §482.12(a)(8)–(9) for hospitals and at 42 CFR §485.616(c) for critical access hospitals (CAHs), making it easier for telemedicine services to be furnished to the hospital’s patients through an agreement with an off-site hospital.
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| Categories: Hospital and Medical Staff, Telehealth
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Your use of the CMA website, including information provided on the COVID 19 Resource Page is governed by the Terms of Use and Privacy Policy linked below.  All CMA Content, including COVID 19 related content, is provided for informational purposes only and is not intended as medical or legal advice, or as a substitute for the medical advice of a physician or the legal advice of an attorney. Physicians should contact their professional liability and other insurers and an attorney for specific advice.

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