Wiki TELEMEDICINE IS GIVING ME A HEADACHE!

Britte

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I have an office who is wanting to do only telemedicine visits, even after COVID. They are a regular outpatient provider office. The will be "seeing patients" on telemedicine visits that are in Skilled Nursing Facilities. Do we use POS 11 , 02 or 31? Do we use outpatient provider E&M codes (example 99212-99215) with modifier 95 or do we use the SNF codes with modifier?

PLEASE AND THANK YOU! I know that COVID changes have allowed everything to be all messy, but any help would be appreciated!
 
The answers to your questions are all payer specific. Most of the payers have published this information on their provider websites. I suggest creating a grid for the various payers, types of telemedicine services, POS/codes/modifiers for those services then start with a payer and start filling in the grid. The guidelines are changing frequently right now as the pandemic period wears on so you'll want to check back regularly for updates.
 
You'll also want to check to see if you are in a Healthcare Professional Shortage Area (HPSA). Before COVID, you had to be in an HPSA to do telemedicine, for most insurances.
 
We have been billing SNF Visits for our Primary Care Providers for Telehealth which is allowed per Medicare through 12/31/21.

99304 - 99306 (SNF - Initial Care) Modifier 95 POS 32
99307 - 99310 (SNF - Subsequent Care) Modifier 95 POS 32

99324 - 99326 (Domiciliary, Rest Home, or Custodial Care Services - New Patient) Modifier 95 POS 33
99335 - 99336 (Domiciliary, Rest Home, or Custodial Care Services - Est Patient) Modifier 95 POS 33

A majority of our SNF patients have Medicare or a Medicare Replacement plan (UHC Medicare, Humana Medicare, Anthem Medicare, etc.) and have been receiving payment for the SNF Telehealth Visits.
 
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