By January 1, 2027 the Secretary must require codes on virtual platform claims
What the document says“Not later than January 1, 2027, the Secretary shall establish requirements to include one or more codes or modifiers, as determined appropriate by the Secretary, in the case of--”
Subsection (g) of section 6209 adds a new paragraph (10) to section 1834(m) of the Social Security Act. By January 1, 2027 the Secretary must require codes or modifiers on claims for telehealth services furnished through a telehealth virtual platform, where the physician or practitioner contracts with the entity that owns the platform or has a payment arrangement with an entity for its use, and on claims for telehealth services furnished incident to a physician's or practitioner's professional service.
What the document actually says“Not later than January 1, 2027, the Secretary shall establish requirements to include one or more codes or modifiers, as determined appropriate by the Secretary, in the case of--”
By January 1, 2027 the health chief must set up a code rule. The rule covers the kinds of claim listed next.
A virtual platform is a company that hosts care by screen. The codes show when a claim came through one. That makes the pattern visible.
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