[David Klebonis]

in reply to: Telemedicine #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.”

[David Klebonis]

in reply to: Telemedicine #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 billing-coding@pbaco.org and we can troubleshoot with you?

[David Klebonis]

in reply to: Telemedicine #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

[David Klebonis]

in reply to: Testing #8058

Dr. A, can you please share the exact code you’re talking about?

[David Klebonis]

in reply to: Telemedicine #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 billing-coding@pbaco.org.

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