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BELOW ARE THE UPDATED COMPLEXITY CODES FOR EVALUATION OF OCCUPATIONAL AND PHYSICAL THERAPY
To access complexity codes, Complexity Codes for Evaluation of Occupational and Physical Therapy_12-30-20.pdf
THIS IS THE LIST OF CPT CODES. 97000 SERIES FOR OT/PT WERE ADDED BUT THEY ARE LIMITED AS TO WHICH CODES.
(March 23,2020 @ 11:50 am)
In response to the COVID-19 outbreak in Arkansas and consistent with CMS’s coverage and payment for COVID-19 diagnostic testing, DMS is suspending the prohibition on use of telemedicine technology for limited occupational, physical or speech therapy services provided to established patients during the COVID-19 outbreak and the declaration of public health emergency.
The telemedicine services described below will be available and billable on April 3, 2020 and will be retroactive to dates of service, March 20, 2020. The services will be available to established patients only, as described for dates of service thirty (30) days from today, with the possibility of extending for additional thirty-day periods.
Parental consultation is a service that allows a therapist to instruct a parent or caregiver on how to use therapeutic equipment or techniques with their child to continue working on therapy goals and objectives.
To bill for this service, the therapist must document that the parent or caregiver was present with a beneficiary. The service must be provided using the appropriate real-time technology that includes both a video and audio component. The originating service requirement is relaxed so that the parent can receive this service from their home.
The service may be provided in 15-minute sessions with a maximum of 8 sessions per month. All services must be prior authorized by eQHealth Solutions.
Individual Therapy Services provided by a Physical Therapist, Occupational Therapist, or Speech Therapist
To allow for continued therapy services for established patients during this time of social distancing, DMS is lifting the requirement that the beneficiary be located at a healthcare facility (originating site) to receive telemedicine services for the following services only: • Individual Physical Therapy provided by a Physical Therapist
• Individual Occupational Therapy provided by an Occupational Therapist • Individual Speech Therapy provided by a Speech-Language Pathologist
Parental or caregiver involvement is required during the session. Additionally, the technology used must be real-time and include a video and audio component. The sessions are limited to thirty minutes a piece, with a maximum of three (3) sessions per week.
The following services cannot be completed via telemedicine:
1. Evaluations and re-evaluations. However, if an annual evaluation is due during this time, the deadline may be extended until the patient is able to come into the office. 2. Services provided by Assistants. 3. Group Services.
To ensure quality and consistency of care to Medicaid beneficiaries, DMS will coordinate with the Office of the Medicaid Inspector General (OMIG) to conduct retrospective reviews and audits of these services during this time. Please keep all records of services as required by Medicaid physician billing and telemedicine rules.