Telemedicine Billing Blog Posts

With the increasing spread of COVID-19 throughout the United States, and the world, the way we’re practicing medicine is changing. Although telemedicine has been available (and billable) for several years, it hasn’t been widely adopted by many within the United States. However, that’s changing. 

As we continue to battle the Coronavirus, we’re going to see more hospitals, practices and patients using telemedicine. Practices need to be prepared to handle telemedicine demands and get up to speed on how to appropriately bill telemedicine. Here’s a closer look at telemedicine and the Coronavirus, and useful information and tips that every practice needs to know. 

Telemedicine — the act of delivering healthcare services remotely via video conferencing and other methods — is a growing trend in the United States. According to the American Hospital Association (AHA), telehealth was practiced in around 35% of hospitals in the nation in 2010. By 2017, that number had grown to 76%. Home telehealth visits also saw significant growth, increasing an average of 52% annually from 2005 to 2014. 

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.