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  • APTA Advisory: Humana Adopts Telehealth for PTs, OTs, SLPs

    PTs can now bill the insurer for common therapy codes, delivered via telehealth, for the duration of the public health emergency.

    Another major commercial payer has acknowledged the value of telehealth provided by PTs: this time, it's insurance giant Humana, which is now reimbursing PTs for services delivered via real-time video-based telehealth. Humana is among the last large national payers to make the shift.

    In a May 15 update, Humana announced that it has expanded its temporary telehealth provisions to include a wider range of providers — PTs, occupational therapists, and speech-language pathologists among them. The expansion applies to both participating/in-network providers and specialty providers, so long as the services don't violate state laws and regulations.

    Similar to CMS, Humana previously had adopted many of the CPT codes commonly used by therapists as billable through telehealth, but didn't include PTs, OTs, and SLPs among the providers able to bill for telehealth services using the codes. That's no longer the case — even for Medicare — and PTs are now able to bill for telehealth services.

    For Humana, the affected codes are 97161-97164, 97110, 97112, 97116, 97535, 97750, 97755, 97760, and 97761. The codes should be accompanied by a place-of-service code — 11, or where services would normally have been furnished — as well as the 95 modifier.

    Humana joins Cigna, UnitedHealth, and Aetna among the payers allowing telehealth by PTs for the duration of the public health emergency. Recently, BlueCross Blue Shield Tennessee became the first large insurer to make physical therapy delivered via telehealth a permanent part of its benefits package.


    • Now, if we can get them to cover Out Of Network, since patients fresh from the hospital are not welcome and are too weak to go to OP and HH (in my area) will not see them until they test negative twice. Most of them are still testing positive, even though they are 30 days or more past onset/hospitalization. Being seen in home by an OP PT is their only option.

      Posted by Dana Lameier on 5/20/2020 7:00 AM

    • Is this allowable for Rehab Agency billing on a UB04? If yes, do we use a special revenue code or condition code? Thank you.

      Posted by Jennifer Ruesewald on 5/20/2020 9:54 AM

    • obligatory "what about institutional billing" question.

      Posted by Dave on 5/20/2020 1:18 PM

    • Does this include assistants?

      Posted by Meredith on 5/20/2020 2:26 PM

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