I am wondering if anyone has solid info on the POS/modifier details needed for Medicare claims. I work for an outpatient psychotherapy practice. I am speaking in reference to CPT codes that I've verified are telehealth-eligible even after the current public health emergency ends (ex: 90837, 90834...)
Prior to the pandemic I believe the coding was POS 02, no modifier needed.
Then very early during the pandemic I was instructed (by who I cannot recall, maybe my claims software provider?) that we should be using POS 11 with modifier 95, as Medicare was trying to track the covid-related sessions that would have been held in-person if not for the pandemic. I've been rolling with that ever since.
Now I have caught wind of new POS 10 to take effect April 2022 which indicates telehealth from a client's home (vs 02 which indicates telehealth from another place, like a nursing home). There are also apparently changes to POS 02 that have stipulations around in-person visits occurring prior to being seen via telehealth ***topic for another day but please chime in if you know about this too, as I've seen conflicting information about whether or not that requirement can be "waived"?
Anyway: Has anyone heard of this? Does this only apply to Medicare and not other insurances? What is the correct way to code outpatient psychotherapy via telehealth for a Medicare client? And also I saw a line in a document emailed to me that says, and I quote, "Medicare hasn’t identified a need for new POS code 10", so what is happening?!
Any/all comments welcome!
