Telemedicine Services
These services or visit are performed not in person face to face. Patient and the provider are at 2 distinct sites.
There are 2 types of telemedicine services. One is Audio only and another is Audio + Video. These services are synchronous telemedicine services.
There are other telemedicine services which are considered as asynchronous telemedicine services example.
Synchronous Audio + Video
The CPT code which has the asterisk (*) symbols Infront of the CPT code are eligible to be furnished via audio + Video and these can be identified in Appendix P in CPT Code book.
Eligible Synchronous Audio + Video EM CPT Codes that can be found in Appendix P, given in beside table
FAQs on Telehealth Billing and Coding Changes
1. What is an originating site in telehealth?
An originating site is the location where a patient receives telehealth services. Before the COVID-19 Public Health Emergency (PHE), patients needed to receive telehealth at an originating site located in a certain geographic location. However, through December 31, 2024, all patients can receive telehealth wherever they're located, and there are no geographic restrictions.
2. What is a distant site in telehealth?
A distant site is the location where a physician or practitioner provides telehealth services. Before the COVID-19 PHE, only certain types of distant site providers could provide and get paid for telehealth. Through December 31, 2024, all providers who are eligible to bill Medicare for professional services can provide distant site telehealth.
3. When should modifier 95 be used for telehealth services?
Modifier 95 should be used when the clinician is in the hospital and the patient is at home, as well as for outpatient therapy services provided via telehealth by qualified PTs, OTs, or SLPs employed by hospitals through December 31, 2024.
4. What are the new POS codes for telehealth services starting January 1, 2024?
Starting January 1, 2024, the new POS codes for telehealth services are:
- POS 02: Telehealth Provided Other than in Patient’s Home
- Descriptor: The location where health services and health related services are provided or received through telecommunication technology. The patient is not located in their home when receiving health services or health related services through telecommunication technology.
- POS 10: Telehealth Provided in Patient’s Home
- Descriptor: The location where health services and health related services are provided or received through telecommunication technology. The patient is located in their home when receiving health services or health related services through telecommunication technology.
5. How does Medicare reimburse telehealth services provided in a patient's home after January 1, 2024?
Starting January 1, 2024, Medicare pays for telehealth services provided to patients in their homes at the non-facility Physician Fee Schedule (PFS) rate.
Synchronous Audio Visit
Telephone Service
These services are provided to the established patient via telephone by physician or other QHP.
99441: 5 to 10 Minutes
99442: 11 to 20 Minutes
99443: 21 to 30 Minutes
Requirement:
Established patient
In person visit should not schedule within 24 hours or urgent available appointment
Telephone service is not billed within 7 days post in person face to face visit.
Note: If the reason of telephone is different that than the face to face in person then we can bill telephone service as well