U.S. Department of Labor Office of Workers’ Compensation Programs

 Division of Coal Mine Workers’ Compensation 

Washington, D.C. 20210

BLBA BULLETIN NO. 20-02

Issue Date: June 4, 2020

Expiration Date: Until Further Notice

Subject: Telemedicine for Routine Medical Services

Background: In response to the COVID-19 pandemic, a number of cities, states, and localities 

have implemented “shelter in place” or “stay-at-home” orders, requiring the closure of nonessential services, and limiting the movements and travel of their residents. Even as some of 

these state and local limitations have been eased, certain medical services may nonetheless still 

be impacted for several months. During this time, the Division of Coal Mine Workers’

Compensation (DCMWC) recognizes the need to implement temporary procedures to allow for 

the use of telemedicine services for some medical treatments provided to miners entitled to 

benefits. In particular, DCMWC finds it appropriate to allow telemedicine services in place of 

in-person non-emergency, routine medical services provided by physicians and other health care 

professionals who work under a physician’s supervision (HCPs).

In issuing this Bulletin, DCMWC is fully aware that some treating physicians and HCPs may be 

constrained in their ability to provide telemedicine services by the requirements of either state 

law or their licensing authorities.  This Bulletin should not be interpreted as countermanding or 

absolving the responsibility to follow those requirements. Such requirements may include, for 

example, that the physician or HCP be physically located in the same state as the miner’s

residence while providing services via telemedicine, or that the physician or HCP be licensed to 

practice in the state where the miner resides. The use of telemedicine services described in this 

Bulletin is optional, not required.

Applicability: Appropriate DCMWC personnel

Purpose: To provide temporary guidance to DCMWC staff in allowing and paying for routine 

medical services utilizing telemedicine when payment is made from the Black Lung Disability 

Trust Fund.

References: 20 CFR 725.701, 20 CFR 725.705, 20 CFR 725.706, 20 CFR 725.707, 20 CFR 

725.708, BLBA Bulletin 18-02.

Action:
1. In accordance with DCMWC regulations, policies and procedures, physicians (including

pulmonologists) and other HCPs may provide routine medical care through telemedicine during 

the period in which this Bulletin remains in effect, when that care is associated directly with an 

accepted condition as outlined under 20 CFR 725.701(e)(1).

2. During the period in which this Bulletin remains in effect, a physician or other HCP can

choose to conduct routine medical treatment utilizing telemedicine options (including phone, 

video conferencing or similar technologies) that they believe will provide appropriate medical 

treatment to the miner, while maintaining the miner’s privacy and safeguarding all protected 

health information.

3. If, in the exercise of their professional judgment, a physician determines that the miner’s 

needs require an HCP on-site with the miner during a telemedicine service, the physician can

have a Registered Nurse (RN), Advanced Practice Nurse Practitioner (APNP), or Physician 

Assistant (PA) present with the miner during the telemedicine service.

4. Physicians and HCPs treating miners via telemedicine can bill utilizing appropriate 

telemedicine billing codes, listing the miner’s address as the location of delivery of the medical 

care. HCPs who were present at the miner’s location during a telemedicine service can bill using 

non-telemedicine billing codes appropriate to their visit. Along with the bill for services, the 

physician or HCP must provide the following information:

a. A note stating the method of telemedicine used;

b. Any vitals or medical evidence collected; and

c. An outline of the medical need and the benefit derived from the service, as it relates 

to the miner’s accepted condition.

5. Physicians can refer miners for pulmonary rehabilitation services, as outlined in BLBA 

Bulletin 18-02. During the period in which this Bulletin remains in effect, a physician can direct 

an RN, APNP, respiratory therapist, or PA to conduct necessary pulmonary rehabilitation 

services at a miner’s home or another place near the miner’s location.

6. DCMWC will routinely review documentation and verify that medical bills are eligible for 

reimbursement prior to payment. If discrepancies are identified, DCMWC staff will work with 

the physician or HCP to resolve any issues.

MICHAEL A. CHANCE

Director, Division of Coal

Mine Workers’ Compensation

Distribution: All DCMWC Staff