Important Changes to Workers' Compensation Telemedicine

Please note the following updates to the telemedicine protocols implemented by the NYS Workers' Compensation Board. This emergency adoption supersedes the previous WCB telemedicine amendment, and is effective immediately.

There are four significant updates, as detailed in section 348.2 (c) below:

  1. Note change in CPT code from 99441 to 99212.
  2. Note addition of billing modifiers
  3. Note addition of telephone only services
  4. Clarification of frequency of services (2x/week 1sts 30 days from injury; 1x/week thereafter in accordance with guidelines).

For those of you who participated in the NYSCA Telemedicine and Workers' Compensation Webinars, most of these updates were anticipated.  You may review the entire amendment here.

The applicable text from this amendment as it impacts telemedicine services rendered by Doctors of Chiropractic is as follows:

325-1.8 Emergency medical aid and telemedicine.

  1. In the event of a serious accident requiring immediate emergency medical aid, an ambulance or any physician may be called to give first aid treatment.
  2. Telemedicine, using two-way audio and visual electronic communication, or treatment via telephone, may be used by authorized providers where medically appropriate for social distancing purposes due to the outbreak of COVID-19 during the state of emergency in accordance with the Department of Health COVID-19 Medicaid Guidance and Guidance issued by the Centers for Medicare and Medicaid Services. The authorized provider shall indicate on their report that such assessment was done using telemedicine by use of modifier 95 and indicating a place of service as 11, or telephonically by indicating place of service as 02. The provider shall also confirm the employee’s identity as well as provide basic information about the services the employee is receiving by telephone or telemedicine. ​

A new subdivision (c) of section 348.2 of Title 12 NYCRR is hereby amended to read as follows:

  1. When medically appropriate, authorized chiropractors shall use Common Procedural Technology (CPT) code 99212 using modifier 95 and indicating 11 as the place of service when treatment is rendered by telemedicine using two-way audio and visual communication, and indicating 02 as the place of service when treatment is rendered by telephone only. Treatment in accordance with section 325-1.8 of this Title and using these codes shall be limited to one unit per patient per day, up to two treatments per week during the thirty days following injury, and up to one treatment per week thereafter.

Please update your procedures as you continue to assist your patients during this pandemic.

Be safe, be well, and assist your patients in a manner consistent with current regulation, best practices and based upon their individual needs (screened urgent patients in office, telemedicine visits as indicated).


Share this post: