Wiki Telemed Change

[AN2114]

I was wondering if anyone can tell me if billing for phone calls has changed recently? Insurance recently has started denying our telemeds. we were using modifier GT but it looks like the insurance my possibly want it billed as an office visit with a 95 modifier. Have there been changes to any of the rules?

 

[Brenda1973]

I was wondering if anyone can tell me if billing for phone calls has changed recently? Insurance recently has started denying our telemeds. we were using modifier GT but it looks like the insurance my possibly want it billed as an office visit with a 95 modifier. Have there been changes to any of the rules?

I code telehealth telephone audio only with these. Our biller adds the modifier. I am not sure which modifier or if any with these telephone CPTs. You would not want to bill a phone visit as an office visit because the phone visits are not considered face to face when video is not used. I bill my telehealth video/audio visits with an E/M office visit level. 99212-99205 with Place of service is a 02. Again our biller adds the modifiers and I am not sure which ones.

• 99441: For telephone visits lasting 5-10 minutes.
• 99442: For telephone visits lasting 11-20 minutes.
• 99443: For telephone visits lasting 21-30 minutes.
• 99444: For telephone visits lasting more than 30 minutes.
• These codes can be used for both new and established patients

 

[ckeeney]

From the HCPCS Level II Modifier listing:
93 Synchronous Telemedicine Service Rendered Via Telephone or Other Real-Time Interactive Audio-Only Telecommunications System
95 Synchronous Telemedicine Service Rendered Via a Real-Time Interactive Audio and Video Telecommunications System

If they are E&M services, Medicare does not allow them as telehealth by phone only. CMS has an approved list of telehealth services with indications of whether or not phone only is allowed. List of Telehealth Services | CMS

You would need to check other payers for their approved telehealth services.