Elizabeth Woodcock Answers Questions about Medical Billing Changes Coming in 2017

As a follow up to our recent webinar, Getting Paid in 2017: What You Need to Know, Elizabeth Woodcock and Kareo have answered the questions posed by participants about the Quality Payment Program (QPP), Chronic Care Management, Telehealth, and coding changes.



Q: Where do I go to find out more about what the measurements are for the QPP?


A: All the measure and improvement activities are listed at qpp.cms.gov. You can review them, select the ones you may want to use and print a list.



Q: For the neutral Pick Your Pace, is it just one quality measure for one patient at one visit?


A: CMS reveals that you can report one quality measure, one improvement activity or the four base Advancing Care Information measures in order to avoid the penalty. See page 3 of this document.



Q: Are chiropractors eligible clinicians for the Quality Payment Program and MIPS?


A: Chiropractors are included on the list of physician types that are covered under the eligible clinicians for the Quality Payment Program. See page 13 of this document.



Q: Do physical therapists participate in MIPS?


A: Physical therapists do not participate in 2017 but they are slated to be added in year three of the program, although you can volunteer to participate if you would like in 2017. However, non-eligible clinicians will not receive a bonus or be subject to penalties. See page 13 of this document.



Q: If we give medical advice over the phone we can use telehealth codes?


A: No, the telehealth codes are specifically for use with telehealth which is defined as a combination of both audio and visual. Plain audio such as a phone call doesn’t qualify.



Q: Can mental health therapists bill for telehealth services?


A: Yes, and telehealth is a particularly good fit for mental health. The use across mental health has been growing. Here is a case study from Kareo on a mental health provider who using telehealth exclusively for her practice.



Q: Are there any changes to CPT codes that are related to the ICD-10 changes from October?


A: The ICD-10 changes do not impact CPT codes. However, here is a link to the fall 2016 changes.



Q: Is the chronic care management considered in any medical field?


A: The intent of CCM is that it be used by the provider that is managing the care plan for a patient with chronic conditions. Usually this is a primary care provider but there are cases where this may be a specialist. The main thing is that the codes be used within the spirit of CCM.



Q: Does Chronic Care Management applies to Medicaid beneficiaries as well?


A: The CCM codes are “regular” CPT® codes, and can be coded and submitted to any payer. However, each payer, including every state Medicaid plan, can make a determination regarding payment. Some cover it; others do not.



Q: Where do I go to find out more descriptive information about how to bill for 99487, 99489, and 99490?


A: The CPT® Manual. We are expecting that CMS will update this memo, but has not yet done so at the time of the webinar.

If you missed the webinar, you can watch the recording.

About the Author

Lea writes educational articles to help medical practices improve their businesses. In addition to Kareo, Lea has written for Medical Manager Health Systems, WebMD...

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