Although there have been some allowances for remote delivery of health care in the Medicare and Medicaid programs for years, the Covid-19 pandemic has accelerated the need for telemedicine visits. Where telehealth visits and other virtual care may have been a specialty before, they are now a necessity.

Just as the rest of the world is changing to meet the demands of the “new normal,” so has telemedicine billing. Medicare has historically limited coverage of telemedicine services primarily to rural healthcare settings. However, this year remote visits have largely become a preferred method of care delivery for the safety of patients and health care professionals alike.

Considered a public health emergency, Covid-19 has made it necessary for government, private payers, and commercial payers to reconsider how they cover telemedicine. The Department of Health and Human Services has relaxed some requirements for telehealth coverage, and commercial payers, at least for the time being, have followed their lead.

Basic Telehealth Billing Requirements

For Medicare beneficiaries, many billing requirements have been relaxed, such as originating sites that aren’t part of the Medicare network. The types of covered telehealth services have also been expanded, restrictions on the types of telecommunication equipment allowed have been eased, and the number of specialties permitted to bill telehealth has been increased.

Other evaluation and management services have seen changes as well. CPT codes have been altered to recognize telehealth visits. For example, modifier 95 is typically used when billing telehealth services to commercial payers, but can be used on an interim basis for Medicare as well.

Despite the existence of Place of Service code “02,” Medicare and most commercial payers want claims to contain the Place of Service (11, 22, etc.) where the service would have been performed if it had been done face to face.

Work With Coding Professionals

Understanding the dynamic world of telehealth can be tricky; it’s hard to keep up with the rapid changes in 2020. MBA Medical Billing Services is here to help you navigate the complex and ever-changing healthcare industry and get paid for your services.

Having issues with your overall billing or the day-to-day process in your office? We provide billing, scheduling, IT services, bookmaking, and more. We will perform a full audit of your procedures and show how we can improve your systems that are already in place.

Want to learn more about how MBA Medical can simplify your office work so you can concentrate on your patients? Schedule a consultation with us today so we can find out where your pain points are. Together, we’ll find a personalized program to cut down on data entry mistakes, improve reimbursements, and make things easier for you and your patients. We look forward to hearing from you.