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TELEMEDICINE

Marisela Posted Wed 11th of March, 2020 13:04:29 PM
With Congress having waived the restrictions on Telehealth/Telemedicine because of the coronavirus, I am needing some guidance on which codes to bill for our Medicare patients should we begin performing telem services. I researched your site and publications, as well as CMS and other site. Am I correct in thinking that we would bill regular EM codes (99212-99215) with the -GT modifier?? I had previously found G0425-G0427, but it seems these are only for ER and/or INPT patients. Thank you!
SuperCoder Answered Thu 12th of March, 2020 11:55:45 AM

Hi Marisela,

Thank you for your question.

The correct code to bill for Telehealth/Telemedicine for medicare patients would be from range 99441 till 99443. There is no notification or any publication to bill 99212-99215 as such for telehealth or telemedicine.

You may also follow the below link for further assistance.

https://www.supercoder.com/coding-newsletters/my-health-information-compliance-alert/telemedicine-master-telemedicine-and-telehealth-coding-with-3-key-tips-161002-article

Feel free to ask for any further query.

Marisela Posted Thu 12th of March, 2020 13:03:57 PM
I am unable to read the article as it is restricted. I had obtained the 99212-99215 as payable 2020 Telehealth codes from the CMS website directly. I just looked up the codes provided (99441-99443) and notice these are all for telephone calls.....would these be the correct code for video conferencing? My research resulted in requirements necessary to bill for telemed/telehealth in that the service must occur via an encrypted internet line via video conference (i.e. laptop). Any additional advice? Thank you!
SuperCoder Answered Fri 13th of March, 2020 03:18:45 AM

Hi Marisela,

As per further detailing (regarding video conferencing) and 2020 code update, It is correct to bill code range 99212-99215, for Telehealth/Telemedicine for medicare patients. However, we will append modifier 95 with these codes. Also, these codes are used for reporting synchronous (real-time) telemedicine services only.

You may check with your documentation if it is a synchronous service.>Before billing these codes you may also need to understand difference between synchronous and asynchronous services.

FYI:

Synchronous programs are those occurring in “real-time”, that is there will be live and two way interaction between patient and provider from distant site. It will include audio as well as video.

Asynchronous programs are delayed communications, that is there will be transfer of diagnostic images or pre-recorded video from one site to another for viewing in preparation for a consult. Hope it helps.

Marisela Posted Fri 13th of March, 2020 10:59:55 AM
Thank you!!
SuperCoder Answered Mon 16th of March, 2020 00:45:09 AM

Thank you, happy to help.

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