edavis107@suddenlink.net
Guest
My name is Tracey and I work for an FQHC. Does anyone bill for Telepsychiatry? We need to know if we can bill for the provider as well as the facility charge if the provider is out of state?
-
If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten your username or password use our password reminder tool. To start viewing messages, select the forum that you want to visit from the selection below..
Wiki FQHC Telepsychiatry
- Thread starter edavis107@suddenlink.net
- Start date
danskangel313
True Blue
- Messages
- 810
- Best answers
- 0
First thing you need to do is reference your state's laws regarding telehealth services to make sure what you're doing is permitted and legal.
The FQHC (as the originating site) where the patient is present will bill the facility charge and the provider at the distant site will bill the professional charge. Because the provider is not located in your facility, you can't bill for their services; the patient is using your equipment, but no professional services are actually being rendered there. Vice versa for the provider.
"FQHCs are authorized to serve as an originating site for telehealth services if the FQHC is located in a qualifying area. An originating site is the location of an eligible Medicare patient at the time the service being furnished via a telecommunications system occurs. FQHCs that serve as an originating site for telehealth services are paid an originating site facility fee."
https://www.cms.gov/Outreach-and-Ed...k-MLN/MLNProducts/downloads/fqhcfactsheet.pdf
"Clinical psychologists (CPs) and clinical social workers (CSWs). CPs and CSWs cannot bill for psychiatric diagnostic interview examinations with medical services or medical evaluation and management services under Medicare. These practitioners may not bill or receive payment for Current Procedural Terminology (CPT) codes 90792, 90833, 90836, and 90838..."
https://www.cms.gov/Outreach-and-Ed...NProducts/downloads/telehealthsrvcsfctsht.pdf
Hope that helps!
The FQHC (as the originating site) where the patient is present will bill the facility charge and the provider at the distant site will bill the professional charge. Because the provider is not located in your facility, you can't bill for their services; the patient is using your equipment, but no professional services are actually being rendered there. Vice versa for the provider.
"FQHCs are authorized to serve as an originating site for telehealth services if the FQHC is located in a qualifying area. An originating site is the location of an eligible Medicare patient at the time the service being furnished via a telecommunications system occurs. FQHCs that serve as an originating site for telehealth services are paid an originating site facility fee."
https://www.cms.gov/Outreach-and-Ed...k-MLN/MLNProducts/downloads/fqhcfactsheet.pdf
"Clinical psychologists (CPs) and clinical social workers (CSWs). CPs and CSWs cannot bill for psychiatric diagnostic interview examinations with medical services or medical evaluation and management services under Medicare. These practitioners may not bill or receive payment for Current Procedural Terminology (CPT) codes 90792, 90833, 90836, and 90838..."
https://www.cms.gov/Outreach-and-Ed...NProducts/downloads/telehealthsrvcsfctsht.pdf
Hope that helps!