Billing > Billing

TELEHEALTH SERVICES

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Mandy1986:
Hello ,

We are going to start telehealth services but i have few question if some one already doing this.

1.   Where to bill – whether Facility /Professional billing.
2.   Which codes to bill for Facility /Professional billing
3.   What cost ?.I have found one person who stated they do telehealth but only as private pay

Michele:

--- Quote from: Mandy1986 on December 19, 2019, 04:22:14 PM ---
1.   Where to bill – whether Facility /Professional billing.

--- End quote ---
I'm not sure what you are asking.  Are you asking what the place of service would be?



--- Quote from: Mandy1986 on December 19, 2019, 04:22:14 PM ---2.   Which codes to bill for Facility /Professional billing

--- End quote ---
The codes are the same as office billing, just that it's being done remotely.




--- Quote from: Mandy1986 on December 19, 2019, 04:22:14 PM ---3.   What cost ?.I have found one person who stated they do telehealth but only as private pay

--- End quote ---
I would say the same fees that you charge for the codes when done in the office.

mimranbilling:
Hi There,

I have a question about Telehealth service billing. Your help is much appreciated.

Question # 1 : if a patient was seen for Telehealth service do we need to send the professional claim with 95/GT modifier with E/M code ?

Example : If the patient was seen via telehealth using (Audio/Video) service for a cough so would the billing will be 99213-95 (Dx code R05) for commercial plans and for medicare 99213-GT (Dx code R05) ? Please confirm. Thank you.

Question # 2 : Can we still bill with telehealth code and POS if patient's and physician had a conversation through only telephone service (AUDIO only) not video or we can only bill such service with 99441-99443 ?

 

Michele:

--- Quote from: mimranbilling on March 24, 2020, 09:36:52 PM ---
Question # 1 : if a patient was seen for Telehealth service do we need to send the professional claim with 95/GT modifier with E/M code ?

Example : If the patient was seen via telehealth using (Audio/Video) service for a cough so would the billing will be 99213-95 (Dx code R05) for commercial plans and for medicare 99213-GT (Dx code R05) ? Please confirm. Thank you.
 

--- End quote ---

I haven't billed any yet but will be this week.  What I am reading is that the GT modifier was eliminated when they implemented the 02 place of service.  The GQ is for telephone only and the 95 is for video/audio.  So in your above example I would do 99213 95 with 02 POS.




--- Quote from: mimranbilling on March 24, 2020, 09:36:52 PM ---Question # 2 : Can we still bill with telehealth code and POS if patient's and physician had a conversation through only telephone service (AUDIO only) not video or we can only bill such service with 99441-99443 ?

 

--- End quote ---

Due to COVID19 they are allowing telephone only.  I believe the codes vary depending on the insurance.  For example, NYS Medicaid is requiring the 99441-99443, but I believe commercial insurance may be allowing the E&M codes.

mimranbilling:
Thank you so much.

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