Wiki e&M code with GT modfier

[Jmsnod]

I work in multi specialty practice with new providers. They want to use 99211-99212 with Gt modifier for telehealth. Will commercial insurance reimburse for this? thanks

 

[danskangel313]

I work in multi specialty practice with new providers. They want to use 99211-99212 with Gt modifier for telehealth. Will commercial insurance reimburse for this? thanks

Medicare has a specific set of rules based on law regarding telehealth and the use of the GT mod here - see pg 4 regarding originating sites:
https://www.cms.gov/Outreach-and-Ed...NProducts/downloads/telehealthsrvcsfctsht.pdf

As far as commercial payers, they will also need to follow the laws regarding the originating sites. This might be a helpful link (scroll down to item 4.):
https://evisit.com/telemedicine-reimbursement-guide-2/

 

[CodingKing]

As far as commercial payers, they will also need to follow the laws regarding the originating sites. This might be a helpful link (scroll down to item 4.):
https://evisit.com/telemedicine-reimbursement-guide-2/

Thanks for the link. This explains why my payer doesn't reimburse for non-Medicare based plans. We are not in one of the states requiring it to be covered. This will be payer/state specific.

 

[danskangel313]

Thanks for the link. This explains why my payer doesn't reimburse for non-Medicare based plans. We are not in one of the states requiring it to be covered. This will be payer/state specific.

You betcha! Sometimes random bookmarked links can come in handy!