Revenue Code For Telehealth Services

In the cy 2018 pfs final rule the requirement to use the gt modifier was eliminated for all.

Revenue code for telehealth services. Hcpcs code 98966 description. Physicians can now offer more services via telehealth and get paid. Bipartisan budget act of 2018 section 50235 amended section 1834 m and mln mm10883. List of services payable under the medicare physician fee schedule when furnished via telehealth.

Telephone assessment and management service provided by a qualified non physician health care professional to an established patient parent or management service provided within the previous 7 days nor leading to an assessment and management service or procedure within the next 24 hours or soonest available appointment. If your payers reject a telemedicine claim and the 95 modifier is not appropriate ask about modifier gt. This cpt code offers reimbursement for providing the patient with a device as defined by the fda. The new pos code became effective january 1 2017.

If an rhc fqhc visit occurs on the same day as a telehealth service the rhc fqhc serving as an originating site must bill for hcpcs code q3014 telehealth originating site facility fee on a separate revenue line from the rhc fqhc visit using revenue code 078x. Hospitals can bill hcpcs code q3014 the originating site facility fee when a hospital provides services via telehealth to a registered outpatient of the hospital. Telehealth services marla dumm cpc ccs p crc managing consultant. Under the emergency waiver in effect the patient can be located in any provider based department including the hospital or the patient s home.

Place of service 02 cms1500 claim revenue codes 096x 097x or 098x cah method ii ub 04 claim source. Covered telehealth services for phe for the covid 19 pandemic effective march 1 2020 zip updated 10 14 2020. Claims for professional services should be submitted using the appropriate service code. Code 99454 covers the actual devices uses by the patient which supply daily biometric recordings and transmissions or program alerts and transmissions and this can be billed every 30 days.

Coverage is retroactive to march 1 2020 and is effective for the duration of the public health emergency phe for covid 19.