Wiki Split Billing on a Telehealth Visit

[rcclary]

Is it possible to do split billing on a telehealth visit? There will be times that the NP will need assistance from the physician with a patient and will bring her in for a telehealth consultation, specifically looking at using this for ADD visits. Is it possible to split the billing on this type of visit or no?

 

[jkyles]

Hi there,
Interesting question. Just to clarify, are you asking about an office visit (99205-99215) performed via telehealth?

 

[rcclary]

Hi there,
Interesting question. Just to clarify, are you asking about an office visit (99205-99215) performed via telehealth?

Let’s say for this instance yes

 

[jkyles]

Then let's say that if the visit fits the guidelines in the CPT manual (visit is coded based on time, providers don't double-count combined time, etc, etc) and the payer allows it: Yes.

That's for coding the visit. The CPT guidelines don't address who bills the service.

 

[AmandaBriggs]

How would you split the billing? The only way to split it, that I'm aware of, is to split it into a 99213-26 and 99213-TC for example. CMS has stated that split shared visits only apply to the facility (hospital) setting and not to office visits. Here is a link to an AAPC blog that discusses this: https://www.aapc.com/blog/84486-upd...furnished independently by only one of them.”

 

[jkyles]

Technical/professional modifiers are not appended to E/M codes.

CMS has rules for split/shared billing that apply to level-based visits in other outpatient and facility settings and to critical care visits. CMS rules determine which individual provider bills the service. The work is split, the payment is not.

CPT split/shared policy describes coding combined work by a physician & QHP for level-based E/M visits that have a time component. Again, the split/shared describes the work, not coding.

Because people sometimes use billing/coding interchangeably I think it never hurts to check.

 

[AmandaBriggs]

You're absolutely correct that office visits aren't split into PC/TC. I updated my response above. Thank you!