Wiki Pennsylvania Medicaid Audio-Only Telehealth Denials

[caitlin1994]

I'm in need of some help here with audio-only telehealth claims for Medicare patients with secondary Pennsylvania Medicaid plans. When billing Medicare (as primary), we use codes 99441-99443. However, we run into a problem with the claim going to secondary. PA Medicaid only accepts G2012 for audio-only telehealth, so when Medicare forwards the claim to secondary (Medicaid), they deny because 99441-99443 isn't on the fee schedule. When we submit a corrected claim with the G code on it, insurance denies because they won't pay on the "new" code since it wasn't the code that was originally processed by Medicare. Is anyone else having trouble with this or have a work-around?

Thanks!