Medicare Advantage incentives for telehealth annual wellness visits during COVID-19 crisis

May 7, 2020

In response to the COVID-19 (Coronavirus) national public health emergency, Independence will offer a new incentive to participating providers who check-in and assess the health and well-being of their Independence Medicare Advantage members via a telehealth visit during this crisis.

Public health emergency telehealth incentive

Last month, we sent letters to providers who have been selected by Independence Medicare Advantage members as their primary care provider (PCP) to share the news about our new telehealth incentive. The incentive is available during the COVID-19 (Coronavirus) national public health emergency. Providers who complete telehealth visits, using both audio and visual means, with their Independence Medicare Advantage members during this crisis can earn $150 after they submit a claim.

As the public health emergency has progressed, Independence has changed the effective date to March 18, 2020, giving providers the opportunity to earn incentives a month earlier than was announced in the letter. We will honor all audio and visual telehealth encounters back to a March 18, 2020, date of service for Medicare Advantage members.

Providers should review current conditions and symptoms, medications, test results, chronic conditions, and overall health status, and discuss preventive care guidelines during the telehealth visit. Please be sure to document your patient’s conditions accurately and completely.

Submitting a claim

When submitting claims for the new telehealth incentive, remember:

  • This new incentive is effective March 18, 2020, and will continue throughout the duration of the national public health emergency, plus an additional 30 days.
  • Only Medicare Advantage members on your panel are eligible for this new incentive.
  • You can earn $150 when you submit a claim/encounter for a telehealth visit (if an in-person visit has not already occurred). The telehealth visit must be completed with both audio and visual features. During the visit, providers should review current conditions and symptoms, medications, test results, chronic conditions, and overall health status. Providers should also discuss preventive care guidelines.
  • The codes that qualify for the incentive are:
    • G0438: Annual Wellness Visit, initial visit
    • G0439: Annual Wellness Visit, subsequent visit
  • The telehealth claim/encounter must report:
    • the appropriate place-of-service code 02 (Telehealth);
    • Modifier 95, which designates synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system.

Payments

Payments will be issued on a monthly basis after the claim or encounter form is processed. Independence will pay one $150 incentive per member upon receipt of the claim/encounter form.

  • Only Medicare Advantage members on your panel are eligible for this new incentive.
  • Only one incentive payment of $150 will be paid per member.

Learn more

If you have any questions about this change, please email our Provider Network Services team at pnsproviderrequests@ibx.com.

For more information about Independence’s position on COVID-19, please review the following resources: