Wiki New E/M codes with POS

[sherrygalla]

Hi, we have begun billing the new telehealth codes for 2025 and are getting denials. Code 98006 with BCBS was denied stating "the procedure code is inconsistent with the place of service". We have always billed a POS of 10 - can anyone please help with this? Should we be using a POS of 02?

 

[csperoni]

Regardless of the denial stating place of service issue, I think the real issue is that the carrier is not recognizing/accepting the new telehealth codes. Medicare has officially stated they are not recognizing them. Any commercial carrier where I've seen guidance has also stated they will not accept the new telehealth codes.
I know there are several BCBS for different states, but I did find this from BCBS NC stating 98006 is not recognized.

https://www.bluecrossnc.com/providers/provider-news/2024/telehealth-cpt-code-set-update

This contains links to their telehealth policy as well for both commercial and Medicare.

Regarding POS 10 vs POS 02, it depends on the location of the patient. From how my providers are performing telehealth, it's 99.99% POS 10.

 

[dhuizar02@msn.com]

Hi, we have begun billing the new telehealth codes for 2025 and are getting denials. Code 98006 with BCBS was denied stating "the procedure code is inconsistent with the place of service". We have always billed a POS of 10 - can anyone please help with this? Should we be using a POS of 02?

For audio only we billed the EM mod 93 and CFI 10