Billing Guidelines For Tele-Health Clinics

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Billing Guidelines for Tele-Health Clinics
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Billing Guidelines for Tele-Health Clinics
Out of numerous changes in the healthcare
industry, CMS has added another one by including
Tele-Health services in the Medicare Payment
Protocol as part of the healthcare emergency
services during the COVID-19 pandemic. As a
result, Tele-Health clinics and healthcare
providers have been facing a few challenges. And,
the biggest concern is relating to the accurate
Tele-Health billing and coding to get no or less
denials. Moreover, it adds on more immense
problems for the practices to stay afloat
especially when Tele-Health clinics are
struggling with the telemedicine services. Hence,
it is essential to know how to code and bill the
telemedicine services accurately. But have you
ever analysed the reasons for such challenges?
The challenges faced by the Tele-Health clinics
are arising usually due to the drastic changes
occurring in the Tele-Health policies. It is
combined with the staff lacking the experience in
keeping up to date with these changes and
documentation. Read more
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Billing Guidelines for Tele-Health Clinics

• Know the Codes for Billing in Tele-Health
  Services
• CMS has approved a list of correct codes for
  billing the Tele-Health services. They are
• G2010 for evaluating the patients' images or
  videos that do not originate from or lead to an
  E/M service.
• G2012 is used for virtual check-in or other
  communication with the healthcare provider using
  some technology.
• G2061 G2063 is established for services like
  assessment and management provided by a
  professional healthcare qualified non-physician
  online.
• 99421-99423 offers an online evaluation and
  management service to an established patient for
  seven days.
• 99441-99443 is to be used when Tele-Health
  services are provided only via telephone.

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Billing Guidelines for Tele-Health Clinics
2. Selecting the Right POS and Modifier There
has been a change in the CMS interim final rule
where the coders during the PHE should not use
the POS 02 Tele-Health. Instead of using the
CMS-1500 form, the coders must enlist POS, which
would be used when there is no PHE. For example,
the coder is to use POS 11 if the beneficiary was
seen at the clinic by the provider. According to
the CMS, the correct modifiers for the
Tele-Health billing amends are 95 Use of audio
and video technology to provide Tele-Health
service G0 In case of symptoms of acute
stroke, there is the diagnosis, evaluation, and
treatment with a Tele-Health service GT
Interactive audio/visual technology is used to
offer telemedicine services GQ Services in
telemedicine are provided through an asynchronous
telecommunication system.
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Billing Guidelines for Tele-Health Clinics
3. Correct Documentation for Reimbursements One
of the reasons Tele-Health clinics find
themselves in loss of revenue is inaccurate and
incomplete documentation. Several factors are
in play when it comes to correct coding and
documentation for the reimbursement of the
services. For instance, the codes differ in the
audio and visual telecommunication tools used
during the service. Also, the provider's
diagnosis, findings, and treatment can change the
coding of the service. Any video consultation
that offers a face-to-face visit with the clinic
must include the billing document apart from the
codes, the platform used, and the date. Likewise,
any patient consulting and getting service via
telephone, email, or other audio tools must be
categorized into non-face-to-face services. It
should also mention the platform through which
such service was provided, like whether it was on
a patient portal or only audio communication
along with the date.
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Billing Guidelines for Tele-Health Clinics
Conclusion To ensure all these guidelines are
followed correctly, the Tele-Health clinics
should outsource their medical billing services
to a Tele-Health billing and coding company. An
experienced medical billing company can conduct
periodic and focused audits to warrant the clinic
about filing its documentation correctly and
compliant with the Medicare Tele-Health revised
guidelines. Also, sometimes it is best to find
additional guidance of expert billers and coders
with updated knowledge of Tele-Health billing
rules and codes upcoming in the healthcare
industry. They can help you to select the right
POS and modifiers while filling the claims to
ensure complete reimbursement and higher
revenues. Therefore, the best way to ensure
efficiency with the coding and documentation
while keeping up with the revised Tele-Health
guidelines is by outsourcing Tele-Health coding
and billing system to a knowledgeable partner
like 24/7 Medical Billing Services.
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Billing Guidelines for Tele-Health Clinics
About Us We are a medical billing company that
offers 24/7 Medical Billing Services and
support physicians, hospitals, medical
institutions and group practices with our end to
end medical billing solutions. We help you earn
more revenue with our quick and affordable
services. Our customized Revenue Cycle Management
(RCM) solutions allow physicians to attract
additional revenue and reduce administrative
burden or losses.
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Billing Guidelines for Tele-Health Clinics
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