Medicare Telehealth Services Expanded for 2012

Better bone up on your telehealth services coding. Physicians and their patients are embracing web-based health solutions at a rapid rate, according to CNBC.com. In keeping with the times, Medicare will cover smoking cessation services in 2012, including those furnished remotely.

The Centers for Medicare & Medicaid Services (CMS) is adding four codes for smoking cessation to the list of distant site telehealth services covered under Medicare Part B, effective Jan. 1, 2012, and adding policy instructions to its manuals. The CPT® and HCPCS Level II codes are:

99406 Smoking and tobacco use cessation counseling visit; intermediate, greater than 3 minutes, up to 10 minutes
99407 Smoking and tobacco use cessation counseling visit; intensive, greater than 10 minutes
G0436 Smoking and tobacco cessation counseling visit for the asymptomatic patient; intermediate, greater than 3 minutes, up to 10 minutes
G0437 Smoking and tobacco cessation counseling visit for the asymptomatic patient; intermediate, greater than 10 minutes

CMS also is allowing initial inpatient telehealth consultation codes G0425-G0427 to be billed when the place of service is in the emergency department. Note the descriptor changes (emphasized):

G0425 Telehealth consultation, emergency department or initial inpatient, typically 30 minutes communicating with the patient via telehealth
G0426 Telehealth consultation, emergency department or initial inpatient, typically 50 minutes communicating with the patient via telehealth
G0427 Telehealth consultation, emergency department or initial inpatient, typically 70 minutes or more communicating with the patient via telehealth

These codes should be submitted with modifier GQ Via asynchronous telecommunications systems or GT Via interactive audio and video telecommunications systems to identify the telehealth technology used to provide the service.

Source: CMS Transmittal 2354, CR 7504, issued Nov. 18.

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