Wiki virtual appointments

Jlokloski

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My doctor is doing virtual office appointments (e.g. I-phone, skype). Is this billed with the office codes 99212-99215, 99201-99205 with modifier 95 and POS 02? I am getting conflicting information on exactly how to code these.

Thank you for any help on this.
 
This is from CMS:
To implement this change on an interim basis, we are instructing physicians and practitioners who bill for Medicare telehealth services to report the POS code that would have been reported had the service been furnished in person. This will allow our systems to make appropriate payment for services furnished via Medicare telehealth which, if not for the PHE for the COVID-19 pandemic, would have been furnished in person, at the same rate they would have been paid if the services were furnished in person. Given the potential importance of using telehealth services as means of minimizing exposure risks for patients, practitioners, and the community at large, we believe this interim change will maintain overall relativity under the PFS for similar services and eliminate potential financial deterrents to the clinically appropriate use of telehealth. Because we currently use the POS code on the claim to identify Medicare telehealth services, we are finalizing on an interim basis the use of the CPT telehealth modifier, modifier 95, which should be applied to claim lines that describe services furnished via telehealth. We note that we are maintaining the facility payment rate for services billed using the general telehealth POS code 02, should practitioners choose, for whatever reason, to maintain their current billing practices for Medicare telehealth during the PHE for the COVID-19 pandemic.

It's basically saying to use the POS that you would if the patient had been seen in your office and to add modifier 95 which tells CMS that it was telehealth. We're using POS 11, 19, or 22 depending on if it is a location that falls under provider based billing rules or not.
 
Amanda is correct. From CMS, the ORIGINAL guidance was POS 02, but then 03/31/2020 new guidelines were the typical POS (11 for most) with -95.
Some of the commercial carriers still want POS 02. Some want modifier -95 or another modifier of their choosing.
 
Has anyone had this scenerio happen? : The physician starts the video/audo visit, it fails (whether there is a disconnect, cannot hear the patient, sound is cutting in and out...etc.) resulting in a telephone visit for the duration of the "appointment". How is this billed? I instructed the provider to document the visit in detail as to how the virtual visit started and the issue causing a switch to telephone only. (The visits were going well between 8-9 am and then seemed to have issues after that.)
 
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