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News & Press: Government Affairs News

CMS Revises Telehealth Billing Guidelines

Friday, April 3, 2020   (0 Comments)
Posted by: Bradley Coffey, MA, AAOE Government Affairs
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Baltimore, MD - The Centers for Medicare and Medicaid Services (CMS) has revised previous guidelines on telehealth billing during the COVID-19 public health emergency. CMS will now reimburse for up to 80 codes performed via telehealth during the public health emergency. CMS' changes include the modifiers and place of service codes that should be used when billing for telehealth services from March 1, 2020 on:

  • The place of service code should be equal to what it would have been had the service been provided in-person.
    • For most AAOE members, this will mean using the place of service code 11 indicating a physician office and not the previously required 02 place of service code.
  • Practices billing for telemedicine visits should use the modifier 95 indicating that the service was actually provided via telehealth.

CMS is not requiring the use of the CR modifier on telehealth services however, in certain instances, an additional modifier will be necessary:

  • If the service is provided as part of a federal telemedicine demonstration project in Alaska and Hawaii using asynchronous (store and forward) technology - GQ modifier
  • If the service is furnished for diagnosis and treatment of acute stroke - G0 modifier

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