MBB f/u visit

[painisfear]

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To those of you utilizing a follow up visit to gather information about MBB (as opposed to a nurse phone call or some other non billable method):

1. Do you need to wait to do the visit until after the global period for the MBB (what is the global period for an MBB)?

2. Are you guys using a telemedicine visit?

 

[Ducttape]

depends on insurance carrier.

Option plans/medicaid - always needs follow up appointment.

i dont think you have to wait until after global period - thats for seeing a patient for potential complications, not for assessing future care.

i have used telemedicine. it works except for medicaid plans.

 

[PinchandBurn]

depends on insurance carrier.

Option plans/medicaid - always needs follow up appointment.

i dont think you have to wait until after global period - thats for seeing a patient for potential complications, not for assessing future care.

i have used telemedicine. it works except for medicaid plans.

I usually do 1 week follow up. Then 1 week to do 2nd mbb thus it's 2 weeks out from mbb #1

 

[clubdeac]

I never do fu for these as I currently am booking out 2 months. I just have them call back with % and duration relief and document it in the chart. Much more time and cost efficient

 

[mdo1738]

Telehealth follow up that same week. Takes about 2 minutes for a 99213 and often a G2211 as well. “Did it work?” If yes, then I say great, we’ll move on to the next step, I’ve got a templated note that all I have to do is sign and then dot phrase to schedulers to get them on the scheduler. If it didn’t work, then they can come in-person for re-evaluation and discussion of other options. Not doing that via phone call.

My schedule is packed full but this adds a minimal amount of work, ensures my MBB#2/RFAs are getting scheduled ASAP instead of vanishing, and is an easy RVU source.

 

[painisfear]

depends on insurance carrier.

Option plans/medicaid - always needs follow up appointment.

i dont think you have to wait until after global period - thats for seeing a patient for potential complications, not for assessing future care.

i have used telemedicine. it works except for medicaid plans.

Thank you

 

[buddababa]

I never do fu for these as I currently am booking out 2 months. I just have them call back with % and duration relief and document it in the chart. Much more time and cost efficient

same

 

[buddababa]

Telehealth follow up that same week. Takes about 2 minutes for a 99213 and often a G2211 as well. “Did it work?” If yes, then I say great, we’ll move on to the next step, I’ve got a templated note that all I have to do is sign and then dot phrase to schedulers to get them on the scheduler. If it didn’t work, then they can come in-person for re-evaluation and discussion of other options. Not doing that via phone call.

My schedule is packed full but this adds a minimal amount of work, ensures my MBB#2/RFAs are getting scheduled ASAP instead of vanishing, and is an easy RVU source.

telehealth is going away in terms of reimbursement as a 99213/4

 

[SSdoc33]

telehealth is going away in terms of reimbursement as a 99213/4

interesting. source?

that would change things for me.

 

[CleanUp]

telehealth is going away in terms of reimbursement as a 99213/4

Interesting! Do you know when this applies? Am I correct in interpreting this for all tele visits then?

 

[buddababa]

interesting. source?

that would change things for me.

my hospital admin, we were getting ready to launch telehealth last month and they put a stop on it - saying as of jan1 2025, rules roll back to pre-covid

 

[SSdoc33]

my hospital admin, we were getting ready to launch telehealth last month and they put a stop on it - saying as of jan1 2025, rules roll back to pre-covid

CMS rule, or individual insurances?

to be honest, i hate doing telehealths, but if they arent going to be paid, then i may have my mbb f/u come in for a 2 minute in person visit. im not giving up those e/m codes. we do the work, we do the documentation, we should get paid for it

 

[buddababa]

i believe cms rule

 

[Ducttape]

cms waited for congress to pass an extension.


1 month 11 days left in the year and i doubt it will come.

 

[clubdeac]

my hospital admin, we were getting ready to launch telehealth last month and they put a stop on it - saying as of jan1 2025, rules roll back to pre-covid

Is this for both telephone and video visits or just televists?

 

[Orin]

Global period for blocks is 0-days
Global period for RFA is 10-days

We don't make money or sense, so we just document in the EMR using patient messages and schedule the next injection or RFA.

 

[buddababa]

Is this for both telephone and video visits or just televists?

reverts back to specific cpt code for telephone, and strict rule for video - can't just bill follow up like we have been

 

[callmeanesthesia]

reverts back to specific cpt code for telephone, and strict rule for video - can't just bill follow up like we have been

I read in a Medicare press release that the CPT committee is deleting the audio only codes.

 

[bedrock]

I read in a Medicare press release that the CPT committee is deleting the audio only codes.

So does that mean as of Jan 1st, we don’t get paid anything for either a zoom or a telephone call?

 

[callmeanesthesia]

So does that mean as of Jan 1st, we don’t get paid anything for either a zoom or a telephone call?

Not sure. I read the Medicare press release and still found it confusing, so I’ve asked our billers for clarification.

 

[Darkside_]

So does that mean as of Jan 1st, we don’t get paid anything for either a zoom or a telephone call?

This is insane. Would be horrible for patient access. They're trying to force us to do more free work.

 

[mdo1738]

Not sure. I read the Medicare press release and still found it confusing, so I’ve asked our billers for clarification.

Link please? I can’t find it

 

[callmeanesthesia]

Link please? I can’t find it

Calendar Year (CY) 2025 Medicare Physician Fee Schedule Final Rule | CMS

On November 1, 2024, the Centers for Medicare & Medicaid Services (CMS) issued a rule finalizing changes for Medicare payments under the PFS and other Medicare Part B policies, effective on or after January 1, 2025.The CY 2025 PFS final rule is one of several final rules that reflect a broader...

www.cms.gov

Scroll down to the Telehealth Services header.

 

[SSdoc33]

Calendar Year (CY) 2025 Medicare Physician Fee Schedule Final Rule | CMS

On November 1, 2024, the Centers for Medicare & Medicaid Services (CMS) issued a rule finalizing changes for Medicare payments under the PFS and other Medicare Part B policies, effective on or after January 1, 2025.The CY 2025 PFS final rule is one of several final rules that reflect a broader...

www.cms.gov

Scroll down to the Telehealth Services header.

you are right. it is a bit ambiguous, but it looks like you can still do telehealth with audio and visual, but not audio only.

not worth my time to futz with a zoom video call. these all will have to come in now. huge waste

 

[callmeanesthesia]

you are right. it is a bit ambiguous, but it looks like you can still do telehealth with audio and visual, but not audio only.

not worth my time to futz with a zoom video call. these all will have to come in now. huge waste

It’s the part about re-implementing geographic restrictions though. I think patients may now have to be in a rural census tract or health professional shortage area to receive telepath from their home.

 

[drrosenrosen]

This is insane. Would be horrible for patient access. They're trying to force us to do more free work.

this is a feature, not a bug

 

[SSdoc33]

sh$t rolls downhill. you can either eat the cost of free work, or pass that responsibility on to the patient. i know what im gonna do

 

[buddababa]

sh$t rolls downhill. you can either eat the cost of free work, or pass that responsibility on to the patient. i know what im gonna do

just like tariffs LOL