Long-Term Care or Palliative Care Facility Billing

Yes. Effective March 20th, if the patient is able to independently use a phone and you feel the encounter could be appropriately provided by Telehealth (video or telephone), bill Long Term Care facility visit fee 00114 or Palliative Care Patient facility visit fee 00127 and include the claim note record “service provided via Telehealth.”

If the patient cannot independently use a phone (e.g. due to debility, dementia, hearing loss etc.) or does not have their own phone, you may review the patient’s medical status and any problems by telephone with an RN/LPN at the facility, and bill the visit using 00114 or 00127 and include the claim note record “service provided via Telehealth with RN/LPN.”

Telehealth fees, the 00114 LTC facility visit fee and the 00127 Palliative Care Patient facility visit fee are not time-based fees, so regardless of the time spent delivering a 00114 or 00127 visit by telephone, you will bill it as a 00114 or 00127 (not a 14077.) You are providing the visit by telephone in lieu of attending the patient in-person.

The rules for 14077 have not changed. 14077 may not be used for conversations with patients. Further, 14077 can not be used for conversations that are part of “routine rounds” simply because they take 8 or more minutes.

The fee rules for 00114 remain the same: billable up to once every 2 weeks for planned proactive care. Medically necessary visits more frequently require an electronic note outlining the reason for the extra visit.

No. The first visit of the day bonuses (13334 and 13338) only apply to in-person visits. They recognize the travel time necessary for attending the facility.

No, MSP has advised that 14076 is the appropriate fee in this case, rather than the 13237 series. If you delegate this telephone visit to a College Certified Allied Care Provider employed by your practice, use T13706 instead.

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