Wiki G2102 vs 99441-99443

mullenslemoine@aol.com

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When to bill G2102 vs 99441-99443 for the emergency telehealth administrative codes that were put out? I am lost on when does it stop being a "brief" communication and become a telehealth E/M? Also, how does MS Medicaid define virtual check in?
 
1) Telephone encounters are NOT telehealth.
A lot of people are misunderstanding this, so I cannot stress it enough.
Telehealth MUST be performed via interactive audio and video. Telehealth is billed as E/M codes 99201-99215 with POS 02. Coding is based as it always was on either the level of hx, exam & MDM, or time if > 50% in counseling/coordination of care. Medicare NO modifier. Commercial mod -95 unless otherwise advised.
Telephone encounter MUST be an established pt, initiated by pt & not related to visit in past 7 days or result in upcoming apt at soonest available. POS 11. Medicare pays for G2012. Commercial may want 99441-99443 or G2012 depending on carrier.

I have zero experience with MS Medicaid to answer that question. I would advise to check with them directly whether they are following CMS guidance or their own policy.

Hope that helps!
 
UPDATE ON 04/02/2020 TO ORIGINAL POST, AS GUIDANCE FROM CMS HAS CHANGED
As of 03/31/2020, CMS states for telehealth, "report the POS code that would have been reported had the service been furnished in person." with modifier -95 to designate it was telehealth. This way, you will get full reimbursement for nonfacility location, instead of reduced facility rate with POS 02.
Medicare will also now reimburse 99441-99443.

Guidance about POS/modifiers page 14-15. Guidance about 99441-99443 starts at bottom of 126.
This is CMS guidance only, and you should check with your commercial carriers about their rules.
 

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