Wiki Telehealth billing for E/M code with add on code; modifier used for 99417?

[scott.jenkins@advancedmd.com]

Hello. I have a client in Washington who is billing telehealth visits for an EM code with 99417. Modifier GT cannot be used with 99417 so how would you bill this? REGENCE of WA requires POS 02 and modifier GT when billing telehealth, but modifier GT is not valid when billing 99417. We billed POS 02 for 99417only, but the claim denied 99417 for invalid POS/modifier. I have received a suggestion to bill both codes with POS 11 and modifier 95, but REGENCE states not to use modifier 95 or POS 11 as this is no longer valid for telehealth. Any suggestions from anyone else billing REGENCE in WA, or AETNA? Thank you in advance.

 

[Blackhorse]

Is your 99205/99215 paid?

 

[kmccarren]

I have the same question only with a Medicaid HMO payer. We are pediatrics. I tried billing using GT and POS 2 - then tried just GT - still cannot get it paid. Any suggestions on how to get this procedure to be recongized?