Medical Billing Forum

Billing => Billing => : arvsun November 08, 2021, 01:06:40 AM

: 95/2 vs 95/11
: arvsun November 08, 2021, 01:06:40 AM

Hello

For outpatient office visits, "Modifier 95 and in office for POS 11" with some insurances pays better than "95/2". Are there recommendations on how to get best reimbursement for tele visits and in choosing 95/11 vs 95/2 - perhaps with additional modifiers and additional codes such as facility codes

If someone has a web reference to an item that clarifies it, that will also really help

Thanks so much
ASG

: Re: 95/2 vs 95/11
: Michele November 10, 2021, 09:07:26 AM

I don't believe it's an option.  Some insurances require that you use the 02 POS and others require the 11 POS.  Some require the 95 modifier, others do not want it.  There is no way to code telehealth to "get best reimbursement".  It has to be coded the way that the insurance requires it.