Telehealth Coding
Telehealth services can be a great way to provide care to patients. By using the correct codes, providers can ensure that they are reimbursed for their services. This can help to make telehealth a sustainable option for providing care.
With the increased use of telehealth services, the Centers for Medicare and Medicaid Services (CMS) has expanded the list of POS codes that can be used for telehealth visits. This is typically the place of service where care would normally occur (Office, Inpatient, emergency, etc). Some carriers require the POS 02 (telehealth provided other than in the patient's home) or POS 10 (Telehealth provided in the patient’s home).
When billing for telehealth services, the place of service code should be reported in addition to the usual procedure codes. The following are some examples of common procedure codes used for telehealth visits:
-99213 (level 3 established patient office visit)
-99214 (level 4 established patient office visit)
-99215 (level 5 established patient office visit)
-99201 (level 1 new patient office visit)
-99202 (level 2 new patient office visit)
-99203 (level 3 new patient office visit)
-99441 (5-10 minutes audio only)
-99442 (11-20 minutes audio only)
-99443 (20-30 minutes audio only)
In addition to the place of service and procedure codes, providers should also report a telehealth modifier when billing for telehealth services. The most common modifier used for telehealth visits is -GT or 95 (denotes that the service was provided via a synchronous telecommunications system).
When using telehealth services, it is important to remember to check with payers to see if there are any specific requirements for coding and billing. Some payers may have different requirements for telehealth visits. By following the correct coding and billing procedures, providers can ensure that they are reimbursed for their services. This can help to make telehealth a sustainable option for providing care.
When billing for telehealth services, it is important to use the correct codes. The Centers for Medicare and Medicaid Services (CMS) have established a set of codes specifically for telehealth services. Proper use of telehealth coding and billing is essential to ensuring that patients receive the care they need. The use of codes 99202-99215 can help ensure that patients receive the care they need while also providing reimbursement for providers.
It is important to note that these codes should only be used when the patient is seen via live video conferencing. If the service is provided through asynchronous means, such as store-and-forward technology, a different set of codes should be used.
See these resources for more information:
https://www.cms.gov/files/document/mm12427-newmodifications-place-service-pos-codes-telehealth.pdf