Wiki MEDICARE POS AND MODIFIER FOR TELEHEALTH AND PHONE behavioral health

[Pkirsch1]

Are the place of service and modifiers the same for MEDICARE Telehealth and phone?
we have modifier 95 and 11 for telehealth and for phone no modifier and 11?

Thank you!

 

[TThivierge]

Pkirsch1
Behavioral health CPT codes can use 93 modifier for phone and 95 modifier for video, but notations must say phone or video in it as mode of treatment. The beh. health CPT codes 90832-90791 Etc. can be used with these modifiers. Now there are phone code for LCSW, LPC , RN nurses can use are CPT 98966-98968 for phone but ensure add minutes on documentation. Psychiatrist and MD can use the CPT 99441-99443 series defining phone calls & add in minutes on record. I do not think the GT modifier no longer used
I hope helped you somewhat
Lady T

 

[Pkirsch1]

Pkirsch1
Behavioral health CPT codes can use 93 modifier for phone and 95 modifier for video, but notations must say phone or video in it as mode of treatment. The beh. health CPT codes 90832-90791 Etc. can be used with these modifiers. Now there are phone code for LCSW, LPC , RN nurses can use are CPT 98966-98968 for phone but ensure add minutes on documentation. Psychiatrist and MD can use the CPT 99441-99443 series defining phone calls & add in minutes on record. I do not think the GT modifier no longer used
I hope helped you somewhat
Lady T

Thank you Lady T! Yes, it helped a lot.

 

[Brenda1973]

Pkirsch1
Behavioral health CPT codes can use 93 modifier for phone and 95 modifier for video, but notations must say phone or video in it as mode of treatment. The beh. health CPT codes 90832-90791 Etc. can be used with these modifiers. Now there are phone code for LCSW, LPC , RN nurses can use are CPT 98966-98968 for phone but ensure add minutes on documentation. Psychiatrist and MD can use the CPT 99441-99443 series defining phone calls & add in minutes on record. I do not think the GT modifier no longer used
I hope helped you somewhat
Lady T

I have a telehealth question, you may be able to help me with. If our LCSW attempts a video encounter but can not connect due to patient not having accessibility to video, would I bill 98966-98968 instead of the 90832-90791? Same question for our Physiatrist encounters that start as video but can't be connected so turn into phone visits. Would I use the phone codes of 99441-99443 vs. 99212-90792?

 

[TThivierge]

Brenda
If any clinician CANNOT bill video or phone note in record not able to connect and use other telehealth mode if available. You could bill LCSW the CPT 98966 if the phone since video for patient not working or can bill beh. health CPT code but add modifier 93 for phone modifier on it once supported. Ensure documentation matches the CPT code selected. Physiatrist I d suggest use CPT 99441 series for phone calls since they are type of physician. Alos they are series of other PT codes to use if face to face with patient which you probably know already.

Physical Medicine and Rehabilitation (PM&R) is also called physiatry. This medical specialty deals with the evaluation and treatment of patients with a disease, disorder, or injury that impairs normal function. The doctor who specializes in physical medicine and rehabilitation is called a physiatrist.

At times the clinician will use the series of other Eval Mgn CPT code and add the modifier 93 or 95 but always document time and mode use in notation for the date treated plus standard HPI,SOAP, meds, discussion and assessments.
I hope helped you
Lady T