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TELEHEALTH SERVICES

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jenniferp:
I am wondering the same about Tricare East......has anyone found out anything on that Q3014 code?

The Tricare manual is VERY confusing about billing this code.  I'm not sure if it's a secondary code we need to add to the claim w/the E&M code or if we should be billing it at all.

HELP!

Thanks!!
Jennifer

RichardP:

--- Quote from: Michele on April 13, 2020, 10:22:51 AM ---Richard, thank you so much for sharing this information.  It is so helpful!

--- End quote ---

You are welcome Michele.

JenniferP - in terms of definitions, the distant site is wherever the physician is.  The originating site is where the patient is.

If the patient is at home, it should be obvious that a home has no authority to bill for a facility fee.  If the patient is at the park, same thing.  But if at a skilled nursing facility or hospital, these do have the authority to bill for a facility fee.  Medicare has lifted the requirements for where the patient must be when engaged in telehealth.  This means that all of the originating sites listed at the link below qualify for telehealth payment during this Covid19 emergency period.  Note that being at home or at the park also qualify - but only during this Covid19 emergency period.

Stated more simply - both the doctor and the patient can be anywhere, and the telehealth encounter will be covered.  But only for so long as this emergency exists.  Medicare will announce when that end point is, but hasn't done so yet.

That is Medicare's stance on the issue.  Your commercial carrier(s) may surprise you with a different stance.

https://www.mgma.com/resources/financial-management/navigating-telehealth-billing-requirements

jenniferp:
Thanks for the responses Michele & Richard P.....

but just so i am clear on Tricare --- we don't have a lot of Tricare pt's ----- but, here's our scenario.

patient calls our office for a telehealth appointment or we have contacted the patient after they or their pharmacy has requested refills on meds, but pt needs to be "seen".  pt is scheduled for a telehealth visit and our front desk contacts them to do "check-in".  front desk advises the time frame that the provider will call them on whichever service they request (facetime, zoom, duo, skype, etc).  our provider is in our normal office location and the patient is at home.  we bill our E&M code and necessary modifier or telehealth place of service, depending on the insurance carriers requirements.

now -- my question is do i append the Q3014 for tricare patients or leave it off because we're in our normal location and the patient is at home and NOT in a SNF, hospital, etc.

just want to make sure we are capturing everything we are supposed to and this is the first time that i have ever seen that Q code.

thanks - signed totally confused - aka jennifer p.

Michele:
You (the provider) are the distant site and would not be billing the Q3014.

jenniferp:
Thank you Michele ---- beyond grateful.   :) :) :) :) :) :) :) :)

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