Claim Denial Telehealth: Check 2 Items Before Refiling

QUESTION: How can we avoid denials for telehealth claims including modifiers? We just received our first denial for a telehealth service using audio-visual. The claim was filed with office visit code 99212, place of service 02 for telehealth and modifier 95. Can you tell us what we did wrong so that we can get paid […]

Cheat Sheet Masters Emergency Telemedicine Policies Coverage

Your head is spinning as you try to recommend remote service solutions to your providers. To make an intelligent presentation to your doctors, you need to do some homework, so you’re getting the coverage you expect and avoiding hot-water regulations. Get a jump start with expert practice management and reimbursement tips from nationally-recognized coding and […]

Virtual Care Tactics That Net You More Pay

Knowing how to correctly code, bill and get paid for remote services (telemedicine) might be the only way your practice can continue to provide services to your patients without risking the spread of COVID-19. Telehealth services reimbursement has become an overnight necessity for many practices with the recent highly-infectious coronavirus outbreak. The challenge is that […]

3 Audit-Proof Telehealth Scenarios That Count as High-Paying 99201-99215

QUESTION: The telehealth rules indicate the service must be patient initiated. What does this mean? We are a pulmonology specialty group and are considering seeing new patient referrals and established patients by Skype. How can the new patient visits meet the office visits’ exam requirements?                      […]

Master 4 FAQs, Increase Your Telehealth Reimbursement

With telemedicine rules changing daily, you’ve got to have a solid foundation in telehealth guidelines, so you can make the most of adding these services compliantly to boost your pay during the COVID-19 pandemic. To help healthcare practices treat more patients virtually, Congress passed legislation that allowed the U.S. Department of Health and Human Services […]

5 Tips Audit-proof Your Remote Patient Monitoring Coding and Billing

An easy way to add $122 per patient per month for services you already offer is to capture 2020’s new and revised CPT codes for remote patient monitoring. But be sure you can keep your hard earned money by reporting compliant, documentation supported claims. With the increasing amount of patients having wearable devices such as […]

2020 CMS Telemedicine: Bill More Services From Eased Locale Rules

The recently released 2020 CMS Telemedicine Policy Final Rule’s changes just went into effect on January 1. Topping the list of improvements are new HCPCS codes, greater flexibility with telehealth location, and more telehealth benefit options. Count Home as Originating Site and 2 Other Sweeping 2020 CMS Telemedicine Changes This major final rule revises payment […]
telehealth originating site

Learn About the 7 Telehealth Originating Sites

Obtaining Medicare reimbursements for telehealth  services isn’t always easy — especially considering CMS telehealth originating site rule restrictions. While telehealth coverage is on the rise, a recent Harris Poll study shows practice adoption has not kept up with patient demand for convenience and better population health care for chronic conditions. CMS recently has agreed to […]

Maximize Billable Opportunities for Coding Remote Patient Monitoring

CMS won’t release the 2020 Medicare Physician Fee Schedule final rule until later this fall, but that doesn’t mean you should wait to shore up your reimbursement for coding remote patient monitoring based on the proposed rule. Released in July, the proposed rule contains important clues about what you can expect next year. And even […]

Updated 2019 Medicare Telemedicine Policy

Several months ago, the Centers for Medicare & Medicaid Services (CMS) released an updated Medicare telemedicine policy for Medicare, which went into effect on Jan. 1, 2019. The new changes in the CMS’ finalized Calendar Year 2019 Physician Fee Schedule for Medicare telemedicine policy are brought with the goal of streamlining the healthcare system, and […]