Wiki Telehealth

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heatherllapczynski@gmail.com

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I am wondering if anyone has any guidance or recommendation on billing virtual telecommunication visits?
How to bill (codes, modifiers, ect...)?
Payer reimbursement?
Any information would help!
Thanks in advance for any information!
 
Hi! A coding consultant posted some great information on Facebook the other day including some key CMS bulletins about Medicare's coverage of telehealth services, what POS to use, and rules for using the codes. It was pretty comprehensive and well-written so linking to it here:
https://www.facebook.com/KimTheCoder/posts/2563674260405751
.

I've also been getting multiple emails a day from all different Medicare Administrative Carriers. If you are coding for a practice in a specific location (e.g., Florida), you can Google "listserv for _____(the name of the Medicare Administrative Carrier - FCSO in the case of Florida)" and it should take you to their web page where you can sign up to receive new bulletins from the MAC. They are really trying to get information out on the regulation changes for using telehealth at this time, and keeping people informed on how to code/bill.

Some key takeaways from Medicare bulletins so far are below.

- Telehealth requires "interactive audio and video connection" that requires "real time communication" capabilities.
- Medicare has shared the following about coding/billing telehealth:

  • Effective for services starting March 6, 2020 and for the duration of the COVID-19 Public Health Emergency, Medicare will make payment for Medicare telehealth services furnished to patients in broader circumstances.
  • These visits are considered the same as in-person visits and are paid at the same rate as regular, in-person visits.
  • Starting March 6, 2020 and for the duration of the COVID-19 Public Health Emergency, Medicare will make payment for professional services furnished to beneficiaries in all areas of the country in all settings.
  • Beneficiary cost share can be waived.
- The latest bulletin also discusses virtual check-ins and E-visits which have different codes and rules: https://www.cms.gov/newsroom/fact-sheets/medicare-telemedicine-health-care-provider-fact-sheet

This information is for Medicare specifically. Private payers can make their own rules. Might not be a bad idea to reach out to provider support centers for your top 5-10 commercial payers or see if they have bulletins on their website with different instructions and payment information. Definitely uncharted territory for us all!

Have a good night
Kim
www.codingmastery.com
 
Our hospital wants to continue to use the 99211-99215 codes with a GT modifier for telehealth. I'm thinking that if we decide to use these codes they cannot be selected simply on time. All key elements must be documented in the note. I'd much prefer the e-visit codes.
Thoughts?
Tim
 
does anyone know if you can bill telemedicine for new patients with the commercial insurances? blue cross, aetna, cigna, humana.
specifically 99201-99205 with 95 modifier and POS 2
 
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