Wiki Telemedicine/Telehealth Question

[AliMontone]

Our practice has a LCSW that has relocated to another state. She had a huge following of patients. The doctor states that our office can bill for telehealth if we have the patients coming into our office and see the LCSW via telehealth. The LCSW is working out of her new state and new office location, no affiliation with us other than possibly still being "an employee." I am unaware if she is billing from her side, but we are billing through ours. I have zero experience with telehealth, but it seems odd that the licensed person is in another state, not credentialed with most of our insurance companies any longer, yet we are to bill the patient/for the patient through our office? I may be completely wrong and that is okay, I would just like a clear comprehension of what our office should be doing. Any help would be appreciated! Thank you!

 

[thomas7331]

You can only bill telehealth services if you meet all of the required criteria. In particular, your practice office where the patients are located would need to qualify as an 'originating site', and the communication system used must be an interactive audio and visual system. The provider can bill for the professional services and the office can bill the originating site charge. In my limited experience with telehealth in the real world, for coding purposes it is sometimes difficult to get good documentation from the remote providers due to the limitations on how much exam can actually be done when the encounter is not face-to-face.

Here's a link to the guide published by CMS that should give you a good starting point as to what is involved with coding and billing telehealth services:

https://www.cms.gov/Outreach-and-Ed...NProducts/downloads/TelehealthSrvcsfctsht.pdf

 

[DRivera921]

Is this true..

When billing for telemedicine visits, you need to use the 95 modifier code for commercial insurance plans, while the “GT” modifier must be included for Medicare and Medicaid plans.