Telemedicine changes

We received the following article from Barbara Griswold and she graciously allowed us to reprint it.

The CPT manual also introduced a new CPT modifier, 95, for “synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system.”  While this will cover video sessions, you’ll notice this description doesn’t apply to phone sessions.  This modifier follows the code for the service provided — ex. If you provided 60 minutes of telemedicine, you would code 90837 with modifier 95. (Note: Many clients don’t have coverage for telehealth.  Also, payers have previously asked providers to use the GT modifier to indicate a telehealth session, so it is a good idea to check with plans before billing).

In addition, the manual clarified that the only codes appropriate for telemedicine are 90832, 90834, 90837, 90845, 90846, and 90847.

What is the Place of Service Code for Telehealth? The APA article suggests when recording the Place of Service code for telehealth sessions that you use the originating code for where the provider is located (typically 11 for office).  However, since the article was written, a new Place of Service Code, 02, took effect (January 1, 2017) to identify “The location where…services are provided or received, through a telecommunication system.”   As always, it is a good idea to check with the insurance plan to see which should be used.   For a complete list of Place of Service codes, click here.

by Barbara Griswold, LMFT, Author of Navigating the Insurance Maze: The Therapist’s Complete Guide to Working with Insurance — And Whether You Should” www.theinsurancemaze.com

 

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