Do you know if IOP visits can be billed for telehealth?

[nwhite123]

Do you know if IOP visits (S9480) can be billed for telehealth? If they can, what modifier should be used, 95 or GT.

Thank you!

 

[MJ4ever]

Do you know if IOP visits (S9480) can be billed for telehealth? If they can, what modifier should be used, 95 or GT.

Thank you!

There is a list of Telemedicine Services Codes in Appendix F in the CPT book, mine is page 636. It lists all CPT codes that you are able to code with modifier 95. It has no HCPCS codes. I wouldn't think S9480 would qualify because it is a day code where a patient needs to be in a group setting for at least 9 hours per week.

 

[nwhite123]

There is a list of Telemedicine Services Codes in Appendix F in the CPT book, mine is page 636. It lists all CPT codes that you are able to code with modifier 95. It has no HCPCS codes. I wouldn't think S9480 would qualify because it is a day code where a patient needs to be in a group setting for at least 9 hours per week.

Thank you!

 

[nwhite123]

Can you tell me if the CPT G0410 can be used as a replacement code for the S9480? We provide IOP services but with COVID they cannot be done in person and are being held via telehealth and we are trying to find an appropriate code to bill for this. Thank you so much for any assistance and guidance you can give me.

 

[SharonCollachi]

If the patients are not at a facility during the day, then they are not in partial hospitalization, so the G code is not appropriate. What exactly are you all doing for the patients?

 

[nwhite123]

Hi Sharon,
We are providing 3 hours of group time, 3 nights per week with a supported meal during each evening with a dietitian or therapist. They are getting three groups each evening, with a combination of CBT, DBT, ACT, relapse prevention, process groups, etc. rotating throughout the week. They are with a licensed clinician and/or dietitian throughout the entire three hours.

I realize that the time qualifies as IOP, but there is not another code that fits better at this time due to telehealth/MA guidelines. Is it ok for to use this code and adjust the time given what we are doing with the clients?

Can you tell me if the CPT G0410 can be used as a replacement code for the S9480?

 

[Alibyd79]

Do you know if IOP visits (S9480) can be billed for telehealth? If they can, what modifier should be used, 95 or GT.

Thank you!

Hi, yes you can bill IOP with rev code 905, HCPCS code s9480 and 3 units if that is the total groups attended. If billing for telehealth you can add modifier GT.