Telehealth Considerations and R590-267, Personal Injury Protection Relative Value Study Rule

BULLETIN 2020-11 State Office Building Suite 3110, Salt Lake City, UT 84114-6901  (801) 538-3800  Facsimile (801) 538-3829  www.insurance.utah.gov State of Utah GARY R. HERBERT Governor SPENCER J. COX Lieutenant Governor Insurance Department TODD E. KISER Insurance Commissioner TO: Auto Insurers Offering Personal Injury Protection Coverage in Utah FROM: Todd E. Kiser, Utah Insurance Commissioner DATE: May 12, 2020 SUBJECT: Telehealth Considerations and R590-267, Personal Injury Protection Relative Value Study Rule Telehealth is increasingly used for patient care, particularly as a result of the COVID-19 pandemic. Payers and providers have raised questions about coding where compensation for telehealth services is governed by the Relative Values for Physicians ("RVP") and the Relative Values for Dentists ("RVD") that are incorporated by reference in R590-267, Personal Injury Protection Relative Value Study Rule. This Bulletin is intended to answer those questions. Rule R590-267 does not specifically list telehealth medical codes or provide instructions for how to use them. However, the American Medical Association has expanded the CPT telehealth code list for the COVID-19 pandemic. Because the RVP and the RVD are based on that CPT code list, telehealth coding is already an option under the RVP and RVD (see the Relative Values for Physicians and the Relative Values for Dentists for details). To identify the proper billing code, a payer or provider should use the telehealth modifier 95 with the appropriate CPT code from the list of CPT codes in Appendix P of the current American Medical Association's CPT codebooks. For dental billing for the COVID-19 pandemic, the American Dental Association has also expanded the CDT code list to include teledentistry codes which may also be used. These codes are also currently an option under the RVD. If you have further questions, please contact Steve Gooch, Public Information Officer, at sgooch@utah.gov. DATED this 12th day of May 2020. _______________________________ Todd E. Kiser Insurance Commissioner