clinical social work association

Below is an update on several issues related to our transition to telemental health services.

1. Zoom – There have been concerns raised about the security of the Zoom platform and Zoom is taking steps to address these issues. A more secure system will be in place by April 5 for the ZoomPro and other platforms Zoom offers.  Here is a summary of what will be happening:

Zoom

We’re always striving to deliver you a secure virtual meeting environment. Starting April 5th, we’ve chosen to enable passwords on your meetings and turn on Waiting Rooms by default as additional security enhancements to protect your privacy.

Meeting Passwords Enabled “On”
Going forward, your previously scheduled meetings (including those scheduled via your Personal Meeting ID) will have passwords enabled. If your attendees are joining via a meeting link, there will be no change to their joining experience. For attendees who join meetings by manually entering a Meeting ID, they will need to enter a password to access the meeting. 

For attendees joining manually, we highly recommend re-sharing the updated meeting invitation before your workweek begins. Here’s how you can do that:

Log in to your account, visit your Meetings tab, select your upcoming meeting by name, and copy the new meeting invitation to share with your attendees. For step-by-step instructions, please watch this 2-minute video or read this FAQ.

For meetings scheduled moving forward, the meeting password can be found in the invitation. For instant meetings, the password will be displayed in the Zoom client. The password can also be found in the meeting join URL.

Virtual Waiting Room Turned on by Default
Going forward, the virtual waiting room feature will be automatically turned on by default. The Waiting Room is just like it sounds: It’s a virtual staging area that prevents people from joining a meeting until the host is ready. 

How do I admit participants into my meeting? 
It’s simple. As the host, once you’ve joined, you’ll begin to see the number of participants in your waiting room within the Manage Participants icon. Select Manage Participants to view the full list of participants , then, you’ll have the option to admit individually by selecting the blue Admit button or all at once with the Admit All option on the top right-hand side of your screen.  For step-by-step instructions, please watch this 2-minute video.

Check out these resources to learn How to Manage Your Waiting Room and Secure Your Meetings with Virtual Waiting Rooms.

For more information on how to leverage passwords and Waiting Rooms to secure your meetings, please visit our Knowledge Center, attend a daily live demo, or visit our Blog.

Please reach out to our Support Team if you have any questions at support@zoom.us.Medicare Issue

Medicare has made several changes in the past few days, revising some previous guidance. Below are some of the most important changes. To see the latest guidance, go to https://www.cms.gov/newsroom/fact-sheets/additional-backgroundsweeping-regulatory-changes-help-us-healthcare-system-address-covid-19-patient 

2. Medicare Coding – the Medicare coding for psychotherapy continues to be in flux.  Here is Guidance which came out today saying we should now use the POS we would have used had the service been provided in person, e.g., “11” for in-office psychotherapy, and the modifier “95”:

Billing for Professional Telehealth Distant Site Services During the Public Health Emergency — Revised (4/3/20)

This corrects a prior message that appeared in our March 31, 2020 Special Edition.

Building on prior action to expand reimbursement for telehealth services to Medicare beneficiaries, CMS will now allow for more than 80 additional services to be furnished via telehealth. When billing professional claims for all telehealth services with dates of services on or after March 1, 2020, and for the duration of the Public Health Emergency (PHE), bill with:

• Place of Service (POS) equal to what it would have been had the service been furnished in-person
• Modifier 95, indicating that the service rendered was actually performed via telehealth

As a reminder, CMS is not requiring the CR modifier on telehealth services. However, consistent with current rules for telehealth services, there are two scenarios where modifiers are required on Medicare telehealth professional claims:

• Furnished as part of a federal telemedicine demonstration project in Alaska and Hawaii using asynchronous (store and forward) technology, use GQ modifier
• Furnished for diagnosis and treatment of an acute stroke, use G0 modifier

There are no billing changes for institutional claims; critical access hospital method II claims should continue to bill with modifier GT.

3. Medicare Reimbursement – this is the area that has seen the most confusion; previous guidance had stated that reimbursement would be the same for telemental health as in-person treatment.  So far, there have been payments made for telemental health that are 7-8% lower than previous reimbursement, some that have remained the same  This seems to vary by region. Contact your MAC to discuss if you have received a payment that is not consistent with previous reimbursement.

4.   Medicare Provider Enrollment - CMS is making it easier for providers to enroll in Medicare. Local private practice clinicians and their trained staff may be available for temporary employment since nonessential planned medical and surgical services are postponed during the pandemic. 

5. Telephonic Coverage – this is the area that has caused the most confusion based on the March 30 guidance: “Building on prior action to expand reimbursement for telehealth services to Medicare beneficiaries, CMS will now allow for more than 80 additional services to be furnished via telehealth. During the public health emergencies, individuals can use interactive apps with audio and video capabilities to visit with their clinician for an even broader range of services. Providers also can evaluate beneficiaries who have audio phones only.” The problem with this statement for LCSWs is that there is only one service that is expanded for psychotherapy, e.g., the E/M 10 minute evaluation, NOT psychotherapy sessions.  CSWA is still working hard to get coverage of telephonic sessions by Medicare.  At present, they are not covered. Continue to let your members of Congress know that this is a problem as noted below. 

CSWA will continue to provide information on regulatory changes to members that affect LCSW practices which will likely be continuing for the next month.

Please let me know if you have any other questions.
Laura Groshong, LICSW, Director, Policy and Practiceww.clinicalsocialworkassociation.org