Telemedicine

[Alexis Miron]

#8040

Tell us about your experiences or methods with Telemedicine.

What are your tactics on communicating or managing your patients?

What are some frequently asked questions from patients?

[David Klebonis]

#8052

The recommended verbal consent language for your progress note is: “Patient consents to and initiated virtual care visit and acknowledges co-insurance”

Best practice for consents is to document at least once per year. If you have any questions, please e-mail [email protected].

[Rooptaz Sibia]

#8059

Telemedicine visits have been getting paid at the usual Medicare rate with place of service 11
For 99213 approximately 78 dollars total. 63 from Medicare and 15 to patient balance or supplement.

[Lori Lane]

#8066

We also have been receiving payment from Medicare for the telemedicine visits – same as reported above.

[Brian Chaney]

#8072

All users should receive automatic email notifications when new topics or comments are posted.

[David Klebonis]

#8078

The reimbursement is NOW the same for telephone E&M as full audio/video E&M.

Below is the updated PBACO bulling guide.

https://pbaco.org/wp-content/uploads/2020/05/PBACO-TELEHEALTH-GUIDE-050420-DK.pdf

[Amy Anderson]

#8080

Are you using a modifier? Previously we were told to use a 95 modifier. We have been getting a lot of denials because we cannot get a straight answer on POS and modifiers.

[David Klebonis]

#8081

Hi Amy,

Every payer and code is different and we can help. Below is a link to the commercial telehealth billing guide. Aetna does not appear to be paying for telehealth 99213, 99203 and Cigna wants a GQ modifier vs. the 95 that most other payers require.

https://pbaco.org/wp-content/uploads/2020/04/Commercial-COVID-19-Telemedicine-Guide_V4-1.pdf

Can you please e-mail us at [email protected] and we can troubleshoot with you?

[Amy Anderson]

#8083

Thank you for that!! That is a great resource.

Also, Dr. K says that he saw somewhere that all televisit and televideo visits that were performed and paid by each insurance, that we are NOT allowed to bill the patient for any copays, co-insurance or deductible.

I have found the Florida Blue guidelines on that and it clearly says “at the member’s current cost share cost.” Are they all doing that as well? Because he told me not to bill even deductibles due as per the EOB.

Thanks for your help!
Amy

[David Klebonis]

#8094

Hi Amy,

I’m not familiar with any payers waiving co-insurance (offering full allowable) for TELEHEALTH, but I’ll reply with an update shortly.

Medicare is waiving co-insurance related to visits that administer or order testing (BELOW).

“Medicare will pay your full claim with no patient cost-sharing if you administer or order COVID-19 testing at that service.

These services are medical visits for evaluation and management when an outpatient provider orders or administers COVID-19 lab test U0001, U0002, or 87635.”

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