Wiki TeleHealth

[coding4fun]

Can someone please assist me with the Telehealth billing? I work in a multi-specialty practice and our Family Medicine docs want to bill for telehealth services. This is a non Medicare pt so it is my understanding that we would bill the appropriate E/M code with a POS of 2. I believe that I understand the 99421-99423 are for ONLINE services only for established patient and 99441-99443 are for TELEPHONE service for established patients. Obviously, we have not billed these codes and I am trying to gain some insight in the understanding of how & when it is appropriate to bill for them. Any help if appreciated. I also understand that there are specific assigned Medicare codes for these services as well but do not believe that we fit any of the criteria for billing for Medicare.

 

[kathleeng]

I am new to this also. I work for an oncology/hematology office. 99441-99443 can be used for new or established patients with new or exacerbating established condition, not seen w/in the last 14 days. See the additional guidelines above the set of codes in the CPT book. It gives you additional information. Regarding insurances, from what I have been researching, the larger healthcare plans are now reimbursing the telehealth codes also. (ie. BCBS, Aetna, Cigna, United Healthcare); some other payers may also recognize them. Here is one of the websites that I found some of my information on.

https://evisit.com/resources/telemedicine-reimbursement-guide/

 

[gilmokar]

According to CMS we can use the desginated E/M codes with POS 02 and modifiers 95, GT, or QT where applicable. Telehealth pdf and you can also visit https://www.cms.gov/Medicare/Medicare-General-Information/Telehealth/Telehealth-Codes Hope this helps!

 

[kelley-ray]

if you bill say 99213 with the GT, 95, or QT where applicable what is the reimbursement for medicare patients, the outpatient amount reimbursed?