Telehealth Billing FAQ

Telehealth or Telemedicine is a new process for many ChoiceEMR users. Along with providers using this functionality, staff will need to know how to bill for these visits as well. 

Q.  What codes are eligible to be billed as Telehealth visits?

A. Office/Outpatient Visits, 99201-99215; Behavioral Health/Psychotherapy Visits, 90791-90792, 90832-90838, and 90845-90847 (Full list available at CMS.)

Q. Do I need to set up a special Service Location for Telehealth visits? (Updated 4/9/2020)

A. Medicare and many other payers have decided that telehealth claims should be billed with a provider's usual place of service, such as POS 11 - Office. However, your State Medicaid may still require the location POS 02 - Telehealth. It is good to have a separate Service Location for these claims/payers. 

Q. Are any modifiers required with these visit codes? (Updated 4/9/2020)

A. Effective 4/1/2020, Medicare is requesting a -95 modifier, or a -GT modifier for Medicare Advantage plans. Commercial payers may require a -95 modifier, or a -GQ modifier, depending on the payer. State Medicaid plans may have their own requirements, so it is important to check with your local plan.

Q. Do I need to set up special Procedure Codes for Telehealth visits? (Updated 4/9/2020)

A. There are two options available with the Choice platform: 1) Create custom Procedure Codes; 2) Use Fee Grouping to allow your usual codes to function as Telehealth codes. When creating these codes, you may want to include a Default Modifier.

Q. Do I need to set up a special Superbill, or a new blue bar on our existing Superbill?

A. It is not required, but many practices find it easier for their provider to select the appropriate codes under a new blue bar on the Superbill.

Q. Can a Telehealth visit be billed from the Superbill in the EMR?

A. Yes. Once the Service Location and the Procedure Codes are set up, then a provider can easily bill a Telehealth visit from the Superbill.

Additional Reference: Medicare Telemedicine Health Care Provider Fact Sheet - CMS