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Telehealth

Marilyn Posted Tue 12th of May, 2020 19:57:13 PM
Group has multiple locations/state. Someone suggested for example that for new providers who have been assigned an office location but have not been to the office yet due to the pandemic but are providing telehealth only , that the facility(32)to be billed as for example: TDC Telecounseling FL and so on for the other states. No address. I disagree. I think the location the patient was scheduled to be seen at should be listed as the place of service with -02.
SuperCoder Answered Wed 13th of May, 2020 07:59:19 AM

Hi,

 

Place of service 32 (Nursing Facility) suggests a facility which primarily provides to residents skilled nursing care and related services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care services above the level of custodial care to other than individuals with intellectual disabilities.

 

Telehealth visits for Medicare patients, per CMS telehealth guidelines, require that you append place of service (POS) code 02 (Telehealth) to indicate “the location where health services and health related services are provided or received, through telecommunication technology.

 

Hope this helps.

 

Thanks.

Marilyn Posted Wed 13th of May, 2020 13:28:57 PM
I'm sorry, pos-32 is incorrect. The question was: Due to COVID19, we experienced a change where HR is staffing new providers that will only be telehealth providers (meaning they will never be associated with an office location) or the provider have not been to an office. When billing, what location do we use? Do we use the provider's home info as pos (-02)and of course billing under the group? If there are no office location yet, ,looking at their NPI# info, there is a primary office location listed associated with the group. Can the listed location be used for billing as pos?
SuperCoder Answered Thu 14th of May, 2020 13:14:45 PM

Hi,

As per the guidelines when billing professional claims for non-traditional telehealth services with dates of services on or after March 1, 2020, and for the duration of the PHE use the POS code that would have been reported had the service been furnished in person along with a modifier 95, indicating that the service rendered was actually performed via telehealth. For example, a provider practicing in an office setting who sees patients via telehealth would report POS 11 (Office). In ordinary circumstances providers use POS 02 (Telehealth) code to indicate the billed service was furnished as a professional telehealth service from a distant site. During the PHE, CMS recognizes that physician practices are transitioning a potentially significant portion of their services from in-person to telehealth visits during the COVID-19 pandemic, yet still incurring resource costs just as they would if services were still furnished in person. CMS states that practices may continue to use POS 02 “should choose, for whatever reason,” but will be paid using the lower facility payment rate.

Hope this helps.

Thanks.

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