Telehealth Coverage for Occupational Therapy
In light of the threat posed by the novel coronavirus, we’re seeing an expansion of telehealth provision. But, the information is tough to track right now, particularly regarding what applies to OT.
The members of the OT Potential Club have been working on pulling together legislative and reimbursement updates, and helping therapists mobilize when key votes arise.
Our role in helping people stay as healthy as possible is so critical right now. And, it is definitely time to mobilize to make sure patients have access to our care.
Below are some telehealth legislative/reimbursement updates from here in the US, but we definitely need your help to keep us up to date.
This is an issue that many of us will be facing individually in our places of work, but my goal is to leverage our community so we can work together on this quickly evolving and incredibly critical issue.
United States Medicare update
Occupational therapists have now been added as an approved telehealth provider for Medicare
We have been waiting for this announcement since March 30, when a CMS announcement spoke of new occupational therapy codes. BUT, for some reason, OTs had not yet been approved as providers. Many therapists were part of the advocacy to finally arrive to the place where we could be approved providers. Thank you for all of your work on this!
We will do our best to keep you appraised of updates as they come out! If we are missing anything, please let us know in the comments.
E-visits and relaxation of HIPAA
A March 17th update from CMS regarding the provision of telemedicine did give OTs the go-ahead to provide e-visits. An e-visit is not a way to deliver full-blown therapy. I’m copying the relevant sections about OT e-visits and the relaxation if HIPAA below:
Clinicians who may not independently bill for evaluation and management visits (for example – physical therapists, occupational therapists, speech language pathologists, clinical psychologists) can also provide these e-visits and bill the following codes:
G2061: Qualified non-physician healthcare professional online assessment and management, for an established patient, for up to seven days, cumulative time during the 7 days; 5–10 minutes
G2062: Qualified non-physician healthcare professional online assessment and management service, for an established patient, for up to seven days, cumulative time during the 7 days; 11–20 minutes
G2063: Qualified non-physician qualified healthcare professional assessment and management service, for an established patient, for up to seven days, cumulative time during the 7 days; 21 or more minutes.
HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA): Effective immediately, the HHS Office for Civil Rights (OCR) will exercise enforcement discretion and waive penalties for HIPAA violations against health care providers that serve patients in good faith through everyday communications technologies, such as FaceTime or Skype, during the COVID-19 nationwide public health emergency. For more information: https://www.hhs.gov/hipaa/for-professionals/special-topics/emergency-preparedness/index.html
Private/commercial insurance coverage update
Shout out to my home state of Nebraska for creating this amazing Google Doc of the information they have gathered from the insurers in our state. If you have a resource like this for your state, please let me know!
State-level update
The reality is that OTs are still tackling some situations on a state-by-state, payor-by-payor basis for private insurance, Medicaid, and other state-funded services. If you are not a member of your state professional organization, it is my recommendation that you join today.
You can also refer to the AOTA chart on State Actions Affecting Occupational Therapy in Response to COVID-19.
There is still a lot in flux and a lot to flesh out. Please let me know in the comments if you have any state-specific updates. And, of course, please verify all information before acting upon it.
Below, you’ll find a list of each state, with a link to where you can find the most current information about telehealth rules and regulations. If you decide to contact your state to seek out more information, we recommend that you ask the following questions:
Can OTs practice telehealth according to state legislation?
Is this temporary legislation?
Can COTAs practice telehealth?
Can those licensed in other states see patients in our state? If so, is this permanent, or is it a temporary waiver?
Do we have any reciprocal arrangements or agreements with other states regarding telehealth provision?
Alabama
Telehealth/COVID-specific info (a COVID-related page added 3/27/2020)
Alaska
Telehealth/COVID-specific info (this is mostly information about license renewals, but might be updated more as things unfold)
Arizona
Telehealth/COVID-specific info (this is a page regarding expansion of telemedicine coverage)
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
Telehealth/COVID-specific info
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Additional Telehealth Resources
We will be seeing many more resources coming out to help us navigate this new era of OT. The AOTA has a telehealth resources page with all of their information. And, at OT Potential, we are gathering information from all of the best sources we can find in our Telehealth Occupational Therapy Guide.
Conclusion
Our world is in flux, and our profession is adapting accordingly.
At OT Potential, we believe that the best way to do this is through collaboration and sharing what is (and what isn’t) working in your practice.
The very best way to leverage our community is by joining the OT Potential Club. The OT Potential Club is our online evidence-based practice forum.
Contributors
Sarah Lyon
OTR/L
Sarah Lyon, OTR/L, is the CEO of OT Potential. Sarah earned her BA from St. Olaf College and her master’s degree in occupational therapy from New York University. Her diverse clinical background spans multiple settings, including critical access, acute trauma, and state inpatient psychiatric hospitals. In 2011, she founded OT Potential to fulfill the industry's need for reliable, high-quality occupational therapy resources and continuing education.
As a recognized content creator, Sarah has collaborated with top healthcare brands like VeryWell Health, WebPT, and MedBridge. She blends her clinical expertise with a talent for creating clear, action-oriented content that empowers practitioners to excel. Passionate about elevating the OT profession, she has been featured on numerous industry podcasts. Sarah ultimately returned to her roots, running OT Potential and raising her family in her hometown of Aurora, Nebraska.