The providers in my practice have been told that we are able to do well child exams via telehealth video calls. They have also been told that they are to bill these visits using the normal well child exam codes with no modifier. This does not sound correct to me. Does anyone have any idea if we are able to actually bill the well child visits that are done over video call and if so, how do we bill for those? Are we just following the guidelines for the other E/M codes?
I am currently researching this as well. One of my pediatricians mentioned this morning that the American Academy of Pediatrics put something out about it
here.
So far I have confirmed that our local BCBS NC says they will pay. Cigna looks like
probably but wording doesn't SPECIFICALLY say well child.
BCBS NC
Patient seen by PCP provider for preventative service/wellness visit.
Use standard evaluation and management CPT ® or HCPCS guidelines, including coding based on time. Codes 99381-99397, 99401-99412 plus Place of Service (02). If audio only, use Place of Service (02) and CR modifier.
https://www.bluecrossnc.com/provider-news/covid-19-additional-details-about-relief-efforts
Cigna states they will pay for any code on their fee schedule as telehealth (except things that would be impossible like a surgery code).
Here is the verbiage from their website:
What services can providers deliver virtually and what will they get reimbursed?
Any service that is currently on a provider’s fee schedule can be provided virtually.* This means that if a provider has a code on their fee schedule today that is reimbursable, they can offer that same service virtually and bill us using the same code (plus the GQ, GT, or 95 modifier), and be reimbursed the full face-to-face amount, at least until May 31, 2020. We will closely monitor and audit claims for inappropriate services that cannot be performed virtually (e.g., surgical codes).
Use POS 11.
* Please note that PT/OT/ST providers have separate guidance.
https://static.cigna.com/assets/chc...ingBusinessWithCigna/medicalDbwcCOVID-19.html
Our other 2 main payers are Aetna and UHC, I am still trying to find/clarify info on those.