Health PAS-OnLine



There were several questions from the Telehealth Webinar held on 4/15/2020 related to COVID-19 Telehealth billing. Below is a response to each question that was captured in the comments of the webinar. The Telehealth policies are located on the BMS website and will be updated as needed per the state and federal directives related to COVID-19. To bill for services rendered through telehealth, bill the services code of the service that was rendered and add the following:If billing on HCFA 1500, bill the appropriate CPT/HCPCS code for the services rendered and use 02 for the Place of Service.If billing on a UB04, bill the appropriate CPT/HCPCS code for the services rendered and add -GT modifier.Telehealth Webinar Questions and ReponsesQuestion: Is there a place where we can find the policy on Telehealth and the CPT codes acceptedResponse: The Telehealth policies can be located on the BMS website:(COVID-19)-Alerts-and-Updates.aspxQuestion: So FQHC for telehealth are billing what codes?Response: FQHC’s are to follow the same billing guidelines and append a GT modifier if the encounter was done via telehealth.Example:Regular visit in the facility billed on a UB04T101599213Telehealth visit (audio or visual) from the facility to the member billed on a UB04T101599213GTQuestion: Is this documentation in the BMS manual?Response: The Telehealth policies can be located on the BMS website:(COVID-19)-Alerts-and-Updates.aspxQuestion: Need accepted CPT codes for Telehealth?Response: No new CPT codes were opened for Telehealth. Please utilize the E&M codes normally billed in the office with a GT modifier to identify that the service was done via telehealth.Question: I was under the assumption it was E/M with GT modifierResponse: Yes, it is the E&M codes previously used with the GT modifier to identify that the service was done via telehealthQuestion: What if patient is at home, if would not be appropriate to bill Q3014 as that is the originating site?Response: No. Q3014 should be billed when a patient has to come in to an eligible originating site to start the telemedicine visit with a healthcare provider at another, distant site. That originating site can then charge a facility fee to cover the costs of hosting the visit.Question: What's about professional office visit?Response: No new CPT codes were opened for Telehealth. Please utilize the E&M codes normally billed in the office with a GT modifier to identify that the service was done via telehealth.Question: What is the revenue code for the Q3014 or is the code Q0134Response: The Q3014 should be billed with the appropriate revenue code that corresponds with the type of visit – medical or behavioral health. Question: Can you indicate what Behavioral Health codes we can use for FQHC also for telehealth when you respond to the FQHC questions.Response: No new CPT codes were opened for Telehealth. Please utilize the Behavioral Health codes normally billed with a GT modifier to identify that the service was done via telehealth.Question: So then if billing the Q3014 will we be paid our full rate? Normally that code is not paid at our full E/M rate. Response: The reimbursement rate for Q3014 is $26.65. This fee is for the originating facility to cover the costs of hosting the visit. Question: We need FQHC Behavioral Health information and well as the eval/mgt or notResponse: No new CPT codes were opened for Telehealth. Please utilize the same E&M and Behavioral Health codes normally billed with a GT modifier to identify that the service was done via telehealth.Question: I need how to bill for Telephone encounter, TeleHealth medical visits and Behavioral Health visit done by LCSW and LPC's done by TeleHealth also for FQHCResponse: No new CPT codes were opened for Telehealth. Please utilize the Behavioral Health codes normally billed with a GT modifier to identify that the service was done via telehealth.Question: Exact coding instructions for FQHC phone visits medical visits.Response: No new CPT codes were opened for Telehealth. Please utilize the same E&M and Behavioral Health codes normally billed with a GT modifier to identify that the service was done via telehealthQuestion: Same Behavioral health has a different rev code for the FQHC so if we do not bill an E/M code the Q code would generate the same rev code for medical and behavioralResponse: Yes, the Q3014 should be billed with the appropriate revenue code that corresponds with the type of visit – medical or behavioral health. Question: May a Licensed Behavioral Health Center group (NPI 1447473475) bill a medical telehealth E/M service with a GT modifier along with the Q3014 during this COVID-19 pandemic?? Or should we only submit a claim for the E/M medical office visit with a GT modifier? Would you also let me know where the Regulation is written? Response: Q3014 should be billed when a patient has to come in to an eligible originating site to start the telemedicine visit with a healthcare provider at another, distant site. That originating site can then charge a facility fee to cover the costs of hosting the visit. The Telehealth policies can be located on the BMS website:(COVID-19)-Alerts-and-Updates.aspxQuestion: We bill for Physician’s Practices and just need to know if there are any special codes or rules set up for billing Molina?Response: No new CPT codes were opened for Telehealth. Please utilize the E&M codes normally billed in the office with a GT modifier to identify that the service was done via telehealthQuestion: Is the virtual care code accepted for telehealth, G2012?Response: No, G2012 is not a covered code. Question: Can you double check with your configuration team regarding FQHC billing as you indicated Q3014 should be billed, however, that is the originating site (i.e. where patient is) and it is inappropriate to ask for payment for the originating site when patient is home.Response: Q3014 should only be billed when a patient has to come in to an eligible originating site to start the telemedicine visit with a healthcare provider at another, distant site.Question: So it was our understanding for telephone and telehealth we bill as follows:E/M code for the work performedT1015Modifier GT on both the E/M and T1015Teledentistry – D9995 and POS 02 in box 38Behavioral healthDistant site allowed for psychiatrist and psychologist onlyPOS 02CPT code for work performed (i.e. individual psychotherapy 90732-90737; initial diagnostic evaluation 90791-90792, etc.)CHIPT1015POS 02CPT code for work performedResponse:?Medical Visit T1015E/M code for the work performed with Modifier GTBehavioral healthDistant site allowed for psychiatrist and psychologist onlyPOS 02CPT code for work performed (i.e. individual psychotherapy 90732-90737; initial diagnostic evaluation 90791-90792, etc.)Dentist VisitTeledentistry – D9995 and POS 02 in box 38CHIPT1015POS 02 (if billed on CMS1500 form)CPT code for work performed ................
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