Question Use of -GT Modifier for TeleHealth

kklink

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With the crisis of Covid-19 our Practice is going to start doing TeleHealth so our older patients do not need to travel out. We are confused on the use of the -GT modifier and receiving conflicting information. Has anyone billed a TeleHealth visit for physician’s office and used the -GT modifier or did you just change the Place of Service Code?
 

csperoni

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NGS Medicare guidance was NO modifiers for telehealth visits for any provider who was not previously able to bill telehealth. So, basically 99.8% of providers who are now billing telehealth during the emergency.
 
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Aetna and IBC are two payers that require this modifier as well as medicare for POS 2
I tried to attach my grid but it wouldn’t allow me to..
 

csperoni

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UPDATE ON 04/02/2020 TO ORIGINAL POST, AS GUIDANCE FROM CMS HAS CHANGED
As of 03/31/2020 interim final rule, CMS states for telehealth, "report the POS code that would have been reported had the service been furnished in person." with modifier -95 to designate it was telehealth. This way, you will get full reimbursement for nonfacility location, instead of reduced facility rate with POS 02.
Medicare will also now reimburse 99441-99443.

Guidance about POS/modifiers page 14-15. Guidance about 99441-99443 starts at bottom of 126.
This is CMS guidance only, and you should check with your commercial carriers about their rules.
Interim final rule: https://www.federalregister.gov/documents/2020/04/06/2020-06990/medicare-and-medicaid-programs-policy-and-regulatory-revisions-in-response-to-the-covid-19-public
 
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