Effective March 20, 2020, WSI is temporarily expanding eligible telehealth services in response to Governor Burgum’s Executive Order 2020-05.1 and in alignment with CMS guidelines. The significant elements for telehealth services are outlined below.
Office Visits
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Visit may utilize an audio-video or audio-only service.
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Originating site may be the injured employee’s home.
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Bill must include appropriate CPT code with Place of Service (POS) 02 and modifier 95.
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Medical documentation must comply with WSI’s E&M Policy. It must also reference the reason for using telehealth and the delivery method.
Therapy
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Therapy service applicable to a remote environment will be allowed.
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Originating site may be the injured employee’s home.
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Utilization Review (UR) requirements and parameters for a therapy service will remain the same. An approval will be honored whether performed in a clinic or via telehealth. A provider may refer to the Utilization Review (UR) Guide for prior authorization requirement details.
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Bill must include appropriate CPT code with Place of Service (POS) 02 and modifier 95.
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Medical documentation must comply with WSI’s Physical Medicine and Rehabilitation Time-Based Services Policy. It must also reference the reason for using telehealth and the delivery method.
WSI does not apply POS differentials to the reimbursement rate. However, reimbursement for telehealth services does not include any originating site facility fees, cell phones, internet connection or other equipment needed to establish the telehealth service. See the WSI Fee Schedule for rates.
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