Telemedicine Billing Blog Posts

Over the past year the Centers for Medicare and Medicaid Services (CMS) has initiated significant changes in how remote patient monitoring (RPM) and other forms of telehealth and telemedicine will be coded and billed. Private payers are following suit in enacting their own billing policies and guidelines. Some states still lag with implementing Medicaid updates and other guidelines but more are starting recognize that transportation expenses and other applicable factors are impacting access to healthcare. Here, we discuss some of the most significant changes including updated CPT codes that telehealth providers and their billing staff need to know.

 Although there have been many discussions about changes to CMS codes and changes to E&M coding for 2019, some of the big changes coming to telemedicine have slipped under the radar. With changes to the 2019 Physician Fee Schedule and new legislation passed in 2018, there are a number of different changes your practice will need to know in the coming year. Here’s a closer look at some of the significant changes in telehealth for 2019 that may actually help your practice boost your bottom line.  

Since telemedicine is a fairly new care method for most patients, telemedicine billing can be a bit tricky. The guidelines for billing and coding for telemedicine are still being formed and they’re changing, and how you bill can depend on the payer.

In the past, when billing Medicare for telehealth services, the GQ and GT modifiers were essential. However, in 2018, CMS has largely eliminated the need to use the GT modifier on telehealth claims, although there are a couple unique situations when CMS still wants GQ and GT modifiers used. Instead, “Place of Service POS 02” codes must be used on claims for telehealth services.

People today are looking for convenience and a variety of ways to communicate -- whether ordering lunch for delivery, taking an Uber to their destination or fitting in a quick doctor's appointment during a 15-minute window when their schedule is too busy to leave the office. Fortunately, the options for telemedicine continue to expand, and adoption rates by consumers of healthcare are improving. While many patients still appreciate the personal touch found in visiting their family doctor and the relationships built over the years with your practice, ignoring the opportunities presented by offering telemedicine means you're risking the loss of others who are treating healthcare as a commodity. See how telemedicine can complement your current offerings and increase patient retention and overall practice revenue.

Telemedicine billing can be a headache because a virtual patient visit isn't the same as an in-person visit, it has to be coded differently. This can lead to errors on claims and give insurance companies grounds to deny payment. In order to get compensation for telemedicine visits, billing departments should keep the following tips in mind when processing bills for payers.