Telemedicine Billing Tips You Need to Know

Telemedicine Billing Tips You Need to Know

Telemedicine is a new rising technology that has great potential to address some of the challenges faced by both developed and developing countries in providing accessible, cost-effective, high-quality health care services.

Telemedicine uses advanced technologies to overcome geographical barriers and increase access to health care services which is the main reason it is playing a pivotal in US healthcare for providing care as rural and underserved communities traditionally suffer from a lack of access to health care.

Covid-19 pandemic forced healthcare industry to go for this model to deliver care and it proved a beneficial for the people. Let’s understand role of telemedicine in Pandemic.

Telemedicine amid Covid-19

During the Covid-19 pandemic, telehealth is emerging as an effective and sustainable solution for the precaution, prevention, and treatment of COVID-19.

Telemedicine is an important tool for bridging the gap between people, physicians, and health systems which helps symptomatic patients to stay at home and communicate with physicians via virtual channels. Moreover, it helps to reduce the spread of the virus to mass populations as well as the frontline medical staff.

As of January 1, 2021, Medicare finalized its telemedicine policy, resulting in coverage extending to 251 types of telehealth services.

After this, there is a significant rise in telehealth services which eventually lead to significant changes in the way patients interact with the healthcare system even after the COVID-19 crisis passes.

Despite the growing prominence of telemedicine amid the pandemic, medical billing for telemedicine can be complicated. In this brief, you will know various billing tips to ease telemedicine billing and faster reimbursement.

Telemedicine Billing Tips

Know various billing codes

All the telemedicine services are covered by Medicare and reimbursement is done based on the standard fee schedule. You should use the appropriate CPT code with a “GT” modifier to indicate the “interactive telemedicine” component.

Moreover, you can select from a variety of HCPCS codes (T1014 and Q3014), CPT codes, and modifiers (GT, U1-UD). However, medical billing and coding guidelines depend on their states’ rules.

At present, 48 states and the District of Columbia provide some form of Medicaid reimbursement for telemedicine services.

CPT Codes Description
99201-99215 Codes for office or other visits.
G0425-G0427 These codes are used for telehealth consultations for both inpatient and emergency departments.
G0406-G0408 These codes are for follow-up inpatient telehealth consultations furnished to beneficiaries in hospitals or SNFs.
99441 – 99443 These telemedicine CPT codes for telephone evaluation and management services by a physician or other qualified health care professional who may report evaluation and management services provided to an established patient, parent, or guardian not originating from a related E/M service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment

Verify smaller commercial payers carefully

When it comes to smaller commercial payers you should verify carefully about their eligibility. While doing it you need to put extra efforts beyond basic eligibility check to asking an actual representative about the telemedicine CPT code in question.

If you find the representative said yes to the services, then you should record that statement (with a reference number or other form of documentation) to resolve any potential billing disputes in the future.

Stay Updated with the industry

You have already aware of the gaining traction of telemedicine due to the COVID-19 crisis and increasingly being utilized by providers and accountable care organizations to bolster primary care delivery and keep consumer costs down.

If you are using telemedicine for delivering care, then you should stay informed about various pilot programs in your area and stay engaged with the evolving laws.

Now, you are aware of telemedicine billing tips and you can handle the billing process easier. However, outsourcing your billing to us is beneficial as our team of medical billing specialists have a 97% clean claim submission rate. We can help you to evaluate the current reimbursement options as well as avoid claim denials and billing errors.

Are You Ready to Get Billing?

Want to hire an experts in telemedicine billing and coding for your practice? You are at the right place, what you need now is a partner who can finish out the rest of the work and make the technology and implementation just as simple. That’s what the best medical billing company like Medisys Data Solutions Inc. can do. If you’re ready to get started, schedule a meeting with our medical billing manager from filling out enquiry form from our website!

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