This falls under the telemedicine area. From a coding perspective, telemedicine services are coded with the appropriate code for services provided and the telemedicine modifier "GT" (Via interactive audio and video telecommunication systems for the service provided) For example, 90806-GT. The key here us real time interactive services. There are some exceptions to the real time rule, but at this point, it isnâ€™t important.
Now, for the reimbursement piece. Check with the carriers, especially your Medicare carrier, to learn their policies for telemedicine services. I am from a commercial carrier and we originally didn't cover telemedicine services, because we questioned the coding and medical appropriateness. A large provider group shared information with us and demonstrated how telemedicine works for some types of services (mental health therapy, for one). We now cover some telemedicine services. Our Medicare carrier does cover telemedicine services and their policies define the criteria.
In your client's case, they should only provide services where their licensure is appropriate. Now, given they are working within the scope of their licensure, they can provide, code, and submit these services. Reimbursement will depend on the carrier or the patient, if self pay is an option.
Hope this is helpful.
- ICD-10 Trainings
- Comprehensive Courses
- CPC (Certified Professional Coder)
- COC (Certified Outpatient Coder)
- CIC (Certified Inpatient Coder) NEW!
- CRC (Certified Risk Adjustment Coder) NEW!
- CPB (Certified Professional Biller)
- CPMA (Certified Professional Medical Auditor)
- CDEO (Certified Documentation Expert – Outpatient) NEW!
- CPPM (Certified Physician Practice Manager)
- CPCO (Certified Professional Compliance Officer)
- VIEW ALL CERTIFICATIONS
Coding / Billing Solutions
- Audit / Compliance Solutions
Job Experience / Apprentice Removal
News / Discussion
- Other Resources
- Book Store
- Log In / Join