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mental health med man services and telemed for medicare

  1. Default mental health med man services and telemed for medicare
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    hello, our company just started to take straight medicare and we are a behavioral health provider. i know the sessions are 90832, 90834 and 90837 . however, im just trying to confirm how the medication management is billed. we usually bill 99213 but that's to medicaid and i know medicare is another ball of wax but i also need to know how to bill the telemed, we currently bill with the GT mod. can anyone help me please or send me the correct direction?

  2. #2
    Location
    Columbia, MO
    Posts
    13,258
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    42 CFR § 410.78(b). To support rural access to care, Medicare pays for telehealth services provided through live, interactive videoconferencing between a beneficiary located at a rural originating site and a practitioner located at a distant site. An eligible originating site must be the practitioner’s office or a specified medical facility, not a beneficiary’s home or office. We will review Medicare claims paid for telehealth services provided at distant sites that do not have corresponding claims from originating sites to determine whether those services met Medicare requirements.”
    That is a start
    Also you no longer use the GT modifier , use the POS 02 instead.

    Debra A. Mitchell, MSPH, CPC-H

  3. Default Claims
    We just started billing telehealth services. Does both the originating site and the distant site submit a claim when both sites are under the same TIN? Also, does the orginating site have to be certified as rural for the services to be billable?

  4. #4
    Location
    Columbia, MO
    Posts
    13,258
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    the originating site is defined as being located in:
    * A county outside a metropolitan Statistical Area
    OR
    * A Rural Health Professional Shortage Area located in a rural census tract.
    The Originating site bills this service using Q3014 the distant site provider uses the appropriate CPT code with the 02 POS

    Debra A. Mitchell, MSPH, CPC-H

  5. Default Billing Q3014 to Medicare
    When billing Q3014, can you specify if it should be billed with the facility as the rendering provider?

  6. #6
    Location
    Columbia, MO
    Posts
    13,258
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    Yes since it is the site that is billing as the originating site and not as a rendering provider.

    Debra A. Mitchell, MSPH, CPC-H

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