Pessie Posted Mon 16th of March, 2020 12:20:19 PM
Due to COVID 19, Providers are inquiring about the proper codes to use, as well as POS. Does Medicare/Medicaid and commercial carriers pay for telephone consults? Can I use the usual e/m code with a GT modifier?
If not, what is the cpt code/modifier? Do I use place of service 02 to indicate telehealth? Do BCBAs have different guidelines?Kindly respond ASAP. Thanks
SuperCoder Answered Tue 17th of March, 2020 08:30:47 AM
Thanks for your question.
Medicare Part B (Medical Insurance) covers certain telehealth services. Telehealth can be used for the treatment for the Coronavirus (COVID-19) from anywhere. Please follow the link below for the reference.
In response to COVID-19 outbreak BCBS of North Carolina has temporary expanded the reimbursement for all services delivered through telehealth that meet the certain criteria. For further details you can refer to link below.
The place of service to indicate telehealth is 02.
Providers most commonly append modifier GT to HCPCS code Q3014, Telehealth originating site facility fee. It is not necessary to use the modifier on every claim line, but facilities should be sure to include the modifier on at least one revenue code claim line for Medicare. The modifier can affect the processing of the payment of the code.
Medicare reimburses modifier GT to only providers who have a licence to provide telehealth services under the laws of their state.
Payers may designate only specific codes the provider may use with this modifier, such as office visit codes 99201 through 99215, neurobehavioral status exam code 96116, and individual medical nutrition therapy codes G0270, 97802, and 97803. Check payer policies for specific codes.
The codes that will be billed for what Medicare actually defines as Medicare “telehealth services” will typically be evaluation and management (E/M) codes (for example, 99213, 99214) along with a telehealth Place of Service (POS) code and potentially a modifier (if required by commercial payer). However, there are additional services available for payment that are not ever restricted by originating site and other Medicare telehealth regulations.
Hope this helps.