Please read carefully.
During a portion of my webinar last evening I reviewed last week’s changes to Telehealth Services. From some of the questions, I felt it necessary to obtain further clarification, so I consulted with my dear friend and coding expert, Dr. Jeffrey Lehrman.
Q: Where can we go to read through the 3/30 guidelines (changes to Telehealth Services)?
A: The 3/30 guidelines came out of The Medicare and Medicaid Programs; Policy and Regulatory Revisions in Response to the COVID-19 Public Health Emergency Interim Final Rule (http://hhs.com/assets/docs/covid-final-ifc.pdf). This link is also at the bottom of apma.org/emremote.
Q: Telehealth Service Option 2 is pretty clear (use code G2012 for Brief communication technology-based service (e.g., virtual check-in) by a physician or other qualified health-care professional who can report evaluation and management services, provided to a new or established patient, not originating from a related E/M service provided within the previous seven days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment; 5–10 minutes of medical discussion. It can be any type of telecommunication tool, including telephone. This does NOT require a modifier, but which POS should be used?
A: Use POS 02
Q: For Option 3 (Telephone Call) I wasn’t able to find codes 99441, 99442 or 99443 in the physician lookup tool through CMS.gov. Where can we find them? AND, Which POS should be used with these codes and is a modifier required? A #1: To find the fees associated with these codes, you go to the individual MAC website and click “Fee Schedules”. For example, here is the Novitas link:https://www.novitas-solutions.com/webcenter/portal/MedicareJL/FeeLookup?_adf.ctrl-state=24cdevx3j_168
A #2: POS 02 with no modifier
Q: For Option 4 (e-visits; which can be performed via EHR/patient portal, text messaging, email, etc.) What is the POS and modifier?
A: POS 02 with no modifier
Q: Can you clarify the reason for using the 95-modifier only for option 1 (Billing regular E/M codes appropriate for the POS where the patient would have been seen; (example 99213 POS 11 (office)?
A: The 95-modifier is only used for services performed remotely that are ordinarily performed face-to-face. So that’s why it only goes on option #1. Because those codes are normally for face-to-face services. For the others, telephone is normally telephone, etc. so the modifier is not needed.
Q: Is Medicare now covering all of these options for established AND new patients?