Wiki Telehealth services vs OV and modifiers

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kathleeng

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With all the new policies coming out right now, I know we can bill 99201-99215 for telehealth services with POS 2 with appropriate modifier also, but I'm trying to distinguish when to bill the OV codes and when to choose the telehealth codes instead. Also, I'm seeing modifier 95 and GT. Some information out there suggests always refer to 95, others say GT. I know it is dependent on the policy, but which is the more likely to be used? Any information would be helpful. We are billing for these now.
 
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Telehealth services are billed with regular OV codes and POS 02 no modifer except for commercial then use 95
Telehealth is synchronous audio and visual medium
Telephone calls are audio only no modifier must be established and patient initiated 99441-99442
E-visit is established patient initiated thru your e-portal no modifier 99421-99423
 
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Am I concerned about billing codes 98966- 98968 vs billing E/M codes via telehealth how can we document a physical exam etc by face to face without being able to actually exam the patient???
 
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jennifers said:
Am I concerned about billing codes 98966- 98968 vs billing E/M codes via telehealth how can we document a physical exam etc by face to face without being able to actually exam the patient???
[/QUOTE

Technically Telehealth Services are for Established Patient's only.
Click to expand...
 
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mitchellde said:
Telehealth services are billed with regular OV codes and POS 02 no modifer except for commercial then use 95
Telehealth is synchronous audio and visual medium
Telephone calls are audio only no modifier must be established and patient initiated 99441-99442
E-visit is established patient initiated thru your e-portal no modifier 99421-99423
Click to expand...
What place of service code are you using for 9944X codes (phone calls)?
 
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BCBS OF NC stated on their telehealth webex last Friday that regular E/M codes could be billed for Telehealth with Modifier 95, but if you have audio only (no video capabilities) then you would use modifier -CR. Their system is set to recognize -CR as Audio only Telehealth visit. However, when you look up the -CR modifier the description is Catastrophe. Any insight on this?
 
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It would seem BCBS of NC created their own policy for this situation, which is different than the CMS guidance and CPT descriptors.
If I had it in writing from that carrier, I would bill per their instructions. I would NOT bill that way without something in writing from the particular carrier, since currently other guidance contradicts that.
 
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