Gloria Posted Wed 08th of April, 2020 15:46:30 PM
With Covid-19 our providers are wanting to start providing non-face-to-face services to patients can I bill out code 90837 and 90853 for the same day? What modifier would I use to signify that these services are non-face to face service would it be modifier GT and 59 or XE?
SuperCoder Answered Thu 09th of April, 2020 10:14:40 AM
Thank you for your question.
Yes, both codes can be billed together provided your documentation justify the need of performing both the procedures on the same day. Payers may ask for documentation to verify the medically necessity.
Bill your services as mentioned below:
As per the changes in telemedicine for COVID-19, bill the codes under place of service “11” instead of POS “02” which was being used for telemedicine.
Bill codes with GT modifier – If Telemed service has been provided through Interactive Audio and Video Telecommunication Systems
Bill codes with GQ modifier - If Telemed service has been provided through Asynchronous Telecommunications System
Bill codes with 95 modifier - If Telemed service has been provided through Synchronous Telemedicine Service Rendered Via A Real-Time Interactive Audio And Video Telecommunications System
Gloria Posted Thu 09th of April, 2020 12:38:51 PM
Hi- Thank you for answering my question. So I would use code 90853 and 90837 at the bottom with modifier 59 and under the place of service, I would use code 02 and modifier GT next to code 59. Also, do I need to have space between code 59 and GT? 90853 90837-59, GT - Lastly, if the client is participating in multiple group therapy sessions on the same day can those be billed out too? And if so how would that look like on a claim form?
SuperCoder Answered Fri 10th of April, 2020 04:25:06 AM
Code 90853 and 90837 needs to be billed with modifier 59, however the place of service will be 11. Also, multiple group therapy sessions can also be billed if documentation justify the need of performing this psychotherapy service on the same day. This code will be billed with modifier 59.
Again, you need to have space between modifiers 59 and GT.
Hope this helps.
Gloria Posted Fri 10th of April, 2020 14:00:30 PM
Hi- I just need to make sure I'm understanding you correctly. If the services are being performed via Zoom, I would put code 90853 on the first line and code 90837 on the second line with modifier 59 and modifier GT and lastly I would put the number 11 as the place of service correct? Thank you!
Gloria Posted Fri 10th of April, 2020 14:05:42 PM
I looked up code 11 and its signifies that services were performed in an office setting. The services are not being performed in the office they are being performed via Zoom so wouldn't I use code 02?
SuperCoder Answered Mon 13th of April, 2020 03:35:17 AM
On March 30, CMS released an interim rule,
CMS is changing the place of service for claims. Do not use POS 02 for CMS telehealth claims, use the place of service that would have been used if the patient had been seen face-to-face.
All these changes are effective March 1, 2020.
Sharing the link below. Hope it helps.
Gloria Posted Mon 13th of April, 2020 15:03:31 PM
I have two more questions, so how is it that the insurance company knows that these services are being performed outside of the office? I attached a link below that says to put 02 on the claim form. Its question number 16. And lastly, I just need to make sure I'm understanding you correctly. If the services are being performed via Zoom, I would put code 90853 on the first line and code 90837 on the second line with modifier 59 and modifier GT? Thank you!
SuperCoder Answered Tue 14th of April, 2020 10:04:35 AM
It is okay to bill 02 place of service in case your farm does not accept 11, since it is an interim situation related to covid-19 both the POS will work.
Yes, you will put code 90853 on the first line and code 90837 on the second line with modifier 59 and modifier GT. Thank you.