reimbursement to value in telehealth - richelle marting - coding & billing

CODING AND BILLING FOR TELEHEALTH

April 2017

OVERVIEW Identification of Codes, Billing Rules Modifiers for Services

MEDICARE TELEHEALTH SERVICES

Psychiatry/Psychology Services Diagnostic evaluation with/without medical services

MEDICARE TELEHEALTH SERVICES

MEDICARE TELEHEALTH SERVICES

MEDICARE TELEHEALTH SERVICES

MEDICARE TELEHEALTH SERVICES

1 hour of 10 hour/year benefit must be face to face

MEDICARE TELEHEALTH SERVICES

MEDICARE TELEHEALTH SERVICES

Subsequent Hospital Care Limited 1 telehealth visit every 3 days Limit doesn’t apply to consults

Subsequent Nursing Facility Limited 1 telehealth visit every 30 days Cannot provide federally mandated initial or periodic visits via telehealth

MEDICARE TELEHEALTH SERVICES

Professional Services -GT: Interactive audit and video telecommunications systems

99203-GT Certifies beneficiary was present Eligible originating site

-GQ: Asynchronous telecommunications system (Alaska, Hawaii) Place of service 02: Telehealth

MEDICARE TELEHEALTH SERVICES

-GT: Interactive audit and video telecommunications systems

99203-GT -GQ

99203 GT

MEDICARE TELEHEALTH SERVICES

Originating Site Services Q3014 Billed by provider/facility where patient is located Fee updated annually 2017 fee: $25.40 80% of originating site fee

QUESTIONSRichelle Marting, JD, MHSA, RHIA, CPC, CEMC, CPMA, CPC-I

rmarting@forbeslawgroup.com

Forbes Law Group, LLC

6900 College Blvd, Ste 840

Overland Park, KS 66211

(913) 341 – 8600