Wiki TELEMEDICINE IS GIVING ME A HEADACHE!

[Britte]

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!

 

[trarut]

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.

 

[SharonCollachi]

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.

 

[njycarter17]

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.

 

[PCPeggy]

Can you bill 99211-99215 for telehealth (audio only) for Medicare

 

[shanamarie]

Can you bill 99211-99215 for telehealth (audio only) for Medicare

No, see the phone codes if Medicare and audio only.

 

[njycarter17]

No, see the phone codes if Medicare and audio only.

She is correct for Medicare - When only audio is done these services may be billed using CPT codes 99441-99443 POS 11