Temporary Telehealth Payment Policy

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washington state department of labor and industries - claims and insurance

Temporary Telehealth Payment Policy 

A detailed temporary telehealth policy from Labor and Industries (L&I) will be published on our website next week. To help support containment of the COVID-19 outbreak this new temporary telehealth policy allows medical providers to use home as an origination site in some instances to treat injured workers. 

L&I's current payment policy and fee schedule already covers phone calls between providers and workers, and telehealth when provided at a medical origination site. Please see the attached PDF for more details of the current policy. 

The new temporary policy will stipulate the following: 

  1. In addition to providing telehealth services under the current payment policy, providers who can normally provide telehealth services using video remote technologies may now bill the following CPT© evaluation and management codes with home as an origination site: 
    1. 99211
    2. 99212
    3. 99213
  2. The documentation requirements will follow the Department payment policy established in Medical Aid Rules and Fee Schedules (MARFS) Chapter 10: Evaluation and Management Services. Under this temporary measure, providers will be required to include a note about the emergency situation (limiting exposure to COVID-19, in this case) that prompted this encounter, as well as noting that the originating site of the worker is home.
  3. Providers are encouraged to implement their clinic’s emergency response plan.

The above policy is effective today. Visit the MARFS Updates and Corrections website for the detailed policy next week. 

On July 3, 2020, the temporary L&I emergency telehealth policy is scheduled to end, unless the Department decides an extension is needed. This is an emerging situation, and this policy may be updated as needed.

Additionally, the temporary policy will state that L&I will not provide the worker with or reimburse the worker for equipment. If a worker doesn’t have access to high-speed internet via computer or a camera phone with reliable connectivity, the provider must work with the worker to identify an alternative.

Claims Administration has decided to instruct claim managers not to automatically stop time loss benefits if the restrictions on an APF expire because the worker was unable to be seen in person due to COVID-19 precautions. Claim managers will be advised to assess each case and staff with their supervisor and/or ONC to decide how best to manage the claim during the period of the forthcoming temporary policy.

Questions on the payment policy after it's published? Contact us at HPPM@Lni.wa.gov.  

LI Telehealth Fact Sheet AUG 2019.pdf