As part of the effort to reduce the spread of COVID-19, the temporary expansion of regulatory flexibility for telehealth services allows providers the ability to continue caring for patients while practicing social distancing. MedCost has received many questions about appropriate billing practices for telehealth services during this public health emergency. For accurate pricing and payment consideration, telehealth services should be accurately coded to reflect the means of delivery, ensuring medically necessary services are appropriately filed according to the following guidelines:
- Professional services (HCFA filers): File with place of service “02” to signify telehealth using applicable telehealth service codes. Modifier “95” is accepted if filed but is not required, and it is recommended that audio and telephonic services (when secure video function cannot be used) are filed with modifier “CR” appended (catastrophe/disaster related).
- Facility services (UB filers): File with the corresponding revenue code for the services being performed. Modifier “95” is required to be appended to all telehealth CPT and HCPCS codes.
- For COVID-19 related services, please ensure your claim is filed with the appropriate COVID-19 diagnosis code(s).
- Services delivered via telehealth should not be billed as though the service was provided in person. MedCost reserves the right to audit for coding accuracy and may deny claims or seek reimbursement for improperly coded claims.
MedCost is closely monitoring developments during the COVID-19 public health emergency and is committed to supporting providers. Please visit our COVID-19 resource page to find answers to your questions. We update this information regularly; however, if you cannot find an answer, please email us at [email protected].