Temporary Telehealth Visits Payment Policy 

To help support containment of the COVID-19 outbreak, the Department of Labor and Industries has issued a new temporary telehealth visits policy. This temporary telehealth policy allows medical providers to use the worker’s home as an origination site in some instances to treat injured workers. This policy is effective 3/9/2020, and expires 7/3/2020. This is an emerging situation, and this policy may be updated as needed.

L&I’s current payment policy and fee schedule already covers phone calls between providers and workers, and telehealth visits when provided at a medical origination site. Please see the DLI Fact Sheet for more details of the current policy: LI Telehealth Fact Sheet AUG 2019.pdf

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.

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.

Policy Does Not Provide Equipment to Workers

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.

Instructions to Claims Managers re: Time Loss Payments

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.  

If you have questions or concerns about your claim, feel free to contact our firm for assistance. We provide a free case analysis and would be happy to discuss your circumstances with you.

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