Wiki Virtual Visits Billing

Sheyla44

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Due to the impact of the Coronavirus, my providers are looking into virtual visits for their patients. We are an OBGYN practice. I am not experienced with this kind of billing and would appreciate any advice from my fellow coders. What is the criteria that needs to be met? CPT codes? Set up? Reimbursement rates/Insurance coverage?

Please, please help!

I hope everyone is staying safe.
 
You may have gotten your questions answered already, I noticed you posted this over a month ago, but because of Covid19 all carriers are accepting Telehealth visits and relaxing their rules with regards to location of practice etc. With that said, my understanding is that you can only bill e/m codes with a POS 2, I'm torn now as to how to bill for the OB telehealth visits. I'm still learning as you can see. Can anyone answer that question?
 
I can tell you that we are not using a special POS. It remains whatever it would have been normally. For prenatal visits and postpartum, we are using our tracking codes and 59430 with a GT modifier. Every virtual visit gets a GT modifier, although some payers require something different, for us this gets flipped on the back end if need be. Video visits can be thought of as an office visit, billed with E&M.
There is a blurb our providers put in like this -
This visit was performed via live interactive two-way video.
During their visit, the patient was informed that their consent to treat includes permission to submit claims to their insurance on their behalf for the services received.
Clinician Location: XYZ
Patient Location: Home

For telephone calls, there are specific codes 99441-99443 and they need to document time as well as patient consent to the call and
The telephone-only visit was being conducted for the purpose of
providing treatment advice during a public health emergency;
The treatment advice that was being provided was based on what
was reported by the patient.
 
What are the billing requirements for 99441-99443? Is it modifier 95 or GT for Medicare? Is it POS actual location or 02?

Peace
?_?
Haven't seen literature on this yet online. Thanks in advance.
 
What are the billing requirements for 99441-99443? Is it modifier 95 or GT for Medicare? Is it POS actual location or 02?

Peace
?_?
Haven't seen literature on this yet online. Thanks in advance.

There is some info here https://www.novitas-solutions.com/webcenter/portal/MedicareJH/pagebyid?contentId=00227310 and https://www.cms.gov/files/document/03092020-covid-19-faqs-508.pdf

These state that the POS is the actual location as if an in person visit. Also 95 modifier is stated. We have been told that Medicare keeps changing things and that instead of 99241 we should use G2012. But that is just what we have been told. Did a brief search but didn't find anything.
 
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