Medical Billing Forum

Billing => Facility Billing => Topic started by: 1UR1 on February 22, 2016, 02:37:29 PM

Title: Billing for Skype/telehealth/telemedicine for substance abuse counseling in CA
Post by: 1UR1 on February 22, 2016, 02:37:29 PM
Hello. Does anyone have experience billing for Skype or other videoconferencing OP sessions in California? Has anyone seen success in getting these paid? I have found a lot of conflicting information about this. If so, what codes/modifiers are to be used? Any helpful information would be appreciated. Thanks!
Title: Re: Billing for Skype/telehealth/telemedicine for substance abuse counseling in CA
Post by: Michele on February 23, 2016, 12:04:57 PM
You mean telemedicine where the provider is not physically in the same location as the patient?  I have not billed it but here is information from CMS regarding it:

http://www.americantelemed.org/docs/default-source/policy/medicare-payment-of-telemedicine-and-telehealth-services.pdf
Title: Re: Billing for Skype/telehealth/telemedicine for substance abuse counseling in CA
Post by: 1UR1 on February 23, 2016, 03:05:32 PM
Thank you Michele! That is what I mean. I am assuming that this also applies to private insurance?

Also, if anyone out there does have experience in this, I'd love to hear from you as well.
Title: Re: Billing for Skype/telehealth/telemedicine for substance abuse counseling in CA
Post by: PMRNC on February 28, 2016, 07:55:00 PM
You won't get reimbursed for this at all, EVEN if you can show medical necessity for not being able to visit the office.
The next reason of course is privacy.. certain platforms may not meet HIPAA standard safeguards.
This is mostly a private pay service and your provider should collect up front. You can try to obtain auth/payment but i's highly unlikely right now.