Question I need detailed description of telecommunications for Medicare telehealth/telemedicine.

tera828@yahoo.com

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Does a telephone call only suffice for Medicare Telehealth E&M billing 99201-99215? Or does it HAVE to be a 2-way audio & video system?
 

eurodurk

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Telephone only, from my understanding, is not enough for Telehealth billing of 99201-99215. To my knowledge, Medicare does not accept the CPT codes 99441-99443, which are the CPT codes that describe a telephone E&M. However, Medicare does accept the HCPCS codes G2012 and G2010, which can be the telephone call alone.

More info here under "Medicare Telehealth Visits" and "Virtual Check-In": https://www.cms.gov/newsroom/fact-sheets/medicare-telemedicine-health-care-provider-fact-sheet
 
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tera828@yahoo.com

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I am looking at the Medicare Telehealth Visits 99201-99215 with POS 02 telecommunications is used in the verbiage and I need to know detail description of telecommunications for this purpose.
 

shanamarie

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I am looking at the Medicare Telehealth Visits 99201-99215 with POS 02 telecommunications is used in the verbiage and I need to know detail description of telecommunications for this purpose.
The service for office visits with POS 02 has to be performed with interactive audio and video in order to bill.
 

b.cobuzzi

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Eurodurk is correct, only G2012 and 2010 are for telecommunications for medicare part B and 99441-443 for non Medicare Part B.

To bill 99201-99215 and other codes, the communications have to be audio-video. The COVID-19 HPAA waivers allow you to use Skype or FaceTime or Zoom if you do not have a telehealth HIPAA approved application.

AAPC is doing a webinar on this topic for $49. I just got an email about it today.
 

afelgner

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These may help you:




Congress passed a law relaxing geographic restrictions and distant site mandates (the patient can be in their home) during the COVID 19 outbreak. CMS also said they are waiving HIPAA privacy rules, and allowing applications such as FaceTime and Skype to be used. The provider must use an interactive audio and video telecommunication system.
 

AKBuckley

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To clarify, for Medicare - if the provider and patient communicate through telephone only (no visual component) it is appropriate to report G2012 with required consent and time spent documented for established patients only. Is the place of service 02 or 11? Thank you -
 

csperoni

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To clarify, for Medicare - if the provider and patient communicate through telephone only (no visual component) it is appropriate to report G2012 with required consent and time spent documented for established patients only. Is the place of service 02 or 11? Thank you -
G2012 is POS 11 as per Barbara's previous VERY helpful summary.
 

b.cobuzzi

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I am finding that depending on the Medicare carrier and non-medicare carrier you call, you get different answers. Some say that POS 02 are used for G2012 and others want 11. G2012 is not Telehealth since it does not involve video. So the best I can tell you is to check with your carrier if you are billing the phone only codes. It definitely is 02 if you are billing audiovideo telehealth services and codes such as 99201-99215. That is how the payer knows the visit is not in the office.
 

gtrombley

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According to CMS sites, they are covering G2012. However, they have denied each one of ours. We have several patients who scheduled telehealth visits, but they were unable to get the video connection to work, so we ended up with the provider talking to them on the phone, instead of video. Does this qualify then for the G2012? Not sure why Medicare is denying the code when they state it should be covered.
Genelle R. Trombley, CPC-P
 

csperoni

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I know some people have had denials stating it's not a covered telehealth service because they are using POS 02 instead of POS 11. NGS Medicare has definitively stated G2012 is POS 11. I have heard secondhand that some Medicare carriers want POS02, but I have not seen it personally. And some commercial carriers are just making up their own rules.
What is the exact denial?
 

gtrombley

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I know some people have had denials stating it's not a covered telehealth service because they are using POS 02 instead of POS 11. NGS Medicare has definitively stated G2012 is POS 11. I have heard secondhand that some Medicare carriers want POS02, but I have not seen it personally. And some commercial carriers are just making up their own rules.
What is the exact denial?
It just stated rejection code 96, Non-covered charge(s). I billed it with POS 02, but realized that the description of "02" is specifically "telehealth." I am re-billing with the pos 11.
 
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