flowergrl
Contributor
A doc recently started billing telehealth office e/m. So far I have figured out the Place of Service requirements and dates when telehealth use has been extended (thru 2024). A few questions, and hopefully someone can post relevant sources to back up rules.
1. Can a provider schedule a future audio-video or audio-only telephone call visit with a patient? Example - patient is in office for follow up. Provider completes the visit and says "Schedule telehealth visit follow up in 1 month". So the scheduler puts the patient on the schedule for a telehealth visit in 1 month. I would think audio-video visit would be coded with regular office visit 99202-99215 codes, pos 11 and modifier 95 until end of 2023 then with 02/10 until end of 2024. However, provider wants to bill 99441-99443 for the audio-only. --- Isn't 99441-99443 only for "patient initiated" visits? As in, the patient comes up with a problem and contacts the office to discuss?
The provider does document "Patient initiated contact for today's visit, called from home." I'm thinking the provider is saying "patient initiated" means the patient starts the visit by calling into the office. So is this audio-only even billable?
2. Provider schedules patient for telehealth visit 10 days after office visit for review of labs results ordered and drawn at the office visit, discussion about patient status and recommendations based on the lab results. This is sometimes audio only and sometimes audio-video based on the patient's level of video access/knowledge. (Again, the patient initiates the call for the visit that day by calling in to the office to start the visit). But it was previously scheduled. What codes can be used? Is Audio-Video still billable for review of labs/advise/medical planning or does it require more medical necessity than that? And again, is 99441-99443 applicable for audio-only if it's scheduled?
What are the documentation requirements for doing telehealth visits? I've spent HOURS online researching and gotten basically nowhere on specifics.
I'm thinking...
1. must document patient consent for telehealth visit.
2. must document why visit is telehealth and not in-person?
3. must document time spent with provider only
4. must document medical necessity for the visit, can't be just to report lab results and advise to continue plan?
1. Can a provider schedule a future audio-video or audio-only telephone call visit with a patient? Example - patient is in office for follow up. Provider completes the visit and says "Schedule telehealth visit follow up in 1 month". So the scheduler puts the patient on the schedule for a telehealth visit in 1 month. I would think audio-video visit would be coded with regular office visit 99202-99215 codes, pos 11 and modifier 95 until end of 2023 then with 02/10 until end of 2024. However, provider wants to bill 99441-99443 for the audio-only. --- Isn't 99441-99443 only for "patient initiated" visits? As in, the patient comes up with a problem and contacts the office to discuss?
The provider does document "Patient initiated contact for today's visit, called from home." I'm thinking the provider is saying "patient initiated" means the patient starts the visit by calling into the office. So is this audio-only even billable?
2. Provider schedules patient for telehealth visit 10 days after office visit for review of labs results ordered and drawn at the office visit, discussion about patient status and recommendations based on the lab results. This is sometimes audio only and sometimes audio-video based on the patient's level of video access/knowledge. (Again, the patient initiates the call for the visit that day by calling in to the office to start the visit). But it was previously scheduled. What codes can be used? Is Audio-Video still billable for review of labs/advise/medical planning or does it require more medical necessity than that? And again, is 99441-99443 applicable for audio-only if it's scheduled?
What are the documentation requirements for doing telehealth visits? I've spent HOURS online researching and gotten basically nowhere on specifics.
I'm thinking...
1. must document patient consent for telehealth visit.
2. must document why visit is telehealth and not in-person?
3. must document time spent with provider only
4. must document medical necessity for the visit, can't be just to report lab results and advise to continue plan?