P02-Telehealth

By Tiffany Lauria,

With the rapid expansion of telehealth services nationally, CMS is continuing to broaden the ability of practitioners to perform alternative visits and have these visits recognized and reimbursed.

Effective January 1, 2017, CMS will recognize a new Place of Service Code: P02- Telehealth. The descriptor for this code is: The location where health services and health related services are provided or received, through telecommunication technology.

The professional service that is being provided via a telecommunications system by the physician or practitioner at the distant site will be paid at the current fee schedule amount for the service provided at the facility rate. Payment for an office visit, consultation, individual psychotherapy or pharmacologic management via a telecommunications system will be made at the same facility amount as when these services are furnished without the use of a telecommunications system. Modifiers GT (via interactive audio and video telecommunications systems) and GQ (via an asynchronous telecommunications system) are still required when billing for Medicare Telehealth services.

Medicare Practitioners who may bill for covered telehealth services include Physicians, Nurse Practitioners, and Physician Assistants, among other clinicians and are subject to state law. The Center for Connected Health Policy: The National Telehealth Policy Resource Center is a non-profit organization that has a repository of state telehealth policies located on their website at: http://www.cchpca.org/. Practitioners may find it helpful to review their state laws when deciding to implement telehealth services into their patient care.

For more information, on code P02-Telehealth, please see CMS change request 9726: https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/downloads/R3586CP.pdf.