Medical Billing Forum
Billing => Billing => : camedbill May 18, 2016, 03:18:42 AM
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I have a therapist who wants to bill telehealth psych services to Medicare and under a psychiatrist (ie 'incident to' billing). Does anyone know if this is kosher? ::)
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Are you asking if it is kosher for the therapist to bill under the psychiatrist or are you asking if telehealth is kosher?
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Hi Michele: I'm asking 1) Does Medicare pay for telepsych service?
2) If so, can it be done as 'incident to'?
Thank you for all your help
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Medicare Telehealth Coverage Areas
There are several conditions to Medicare telehealth coverage. The first being that the consumer, or individual receiving telehealth services must be physically located in an “originating site” that is eligible for Medicare coverage.
Those sites include:
• A health Professional shortage area (HSPA).
• Outside a Metropolitan Statistical Area (MSA)
• Within a MSA rural census tract determined by HHS’s Office of Rural Health Policy. (More here)
• Rural areas as defined by the department of health and human services (HRSA)
You can find out if your location is covered by these conditions here: http://datawarehouse.hrsa.gov/tools/analyzers/geo/Telehealth.aspx
There are also entities that participate in a federal telemedicine demonstration project approved by or receiving funding from the Secretary of the Department of Health and Human Services that qualify as originating sites regardless of their location. These include:
• The offices of physicians or practitioners
• Hospitals
• Critical Access Hospitals (CAH)
• Rural health clinics (RHC)
• Federally Qualified Health Centers (FQHC)
All telemedicine encounters must take place in real-time, face-to-face interactions using audio and video equipment at both consumers’ and physicians’ locations.