Wiki Billing MD vs. Rendering MD

[Jtolleson]

We are about to take over billing for a group practice. There is a location in CA and a location in FL. They have requested that the visits that take place at the FL location be billed with a provider from the CA location as rendering provider. My instinct says this is not compliant in any form or fashion but they say they were billing this way with their previous biller so I need some documentation to support my feelings or prove my feelings wrong.

I was told that as long as the MD in CA provided a telehealth visit then the claims could be billed under him but does this mean the MD in FL can see a patient, bill under another MD at another location and be covered as long as the off location doc provides an occasional telehealth visit? Has anyone ever heard of such? I think it sounds like a mess waiting to happen but would love some direction on where I could obtain supporting documentation.

Thanks in advance!

 

[CodingKing]

Here is some information from CMS on Telehealth.

https://www.cms.gov/Outreach-and-Ed...NProducts/downloads/TelehealthSrvcsfctsht.pdf

&

190 - Medicare Payment for Telehealth Services:
https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/clm104c12.pdf

Basically, The Florida provider can only bill the Originating site fee (Q3014). The CA physician bills for the actual service with appropriate modifier. This is only when an actual telehealth services are provided. The distant provider cannot bill for services under teleheath if not providing a telehealth service