This Quick Reference Guide, is meant to serve as a guide for billing telephonic and video visits. In this guide we will define Telemedicine as any interactions between the provider and patient via telephone call, and or video conferencing.
This Guide only applies to Telemedicine related interactions with patients and NOT for regular in office visits.
Frequently Asked Questions
Please review the follow frequently asked questions before continuing:
- Patient needs to acknowledge consent, verbal consent is acceptable.
- Practice's managing their own billing - all encounter charges for Telemedicine, video & audio visits, must update Place of Service to ‘Telehealth".
3. Use the Intake/SOAP template, like a standard office visit.
Telephone Only Medicare Advantage Visits
When Finalizing Telephone only visits for Medicare Advantage patients:
- Select from the list of Phone only codes.
- Click Submit Code.
Since the Code is manually being selected. The Medical Decision Making will not be necessary.
Telephonic Calls with Video Medicare Advantage Visits
When Finalizing visits for Telephonic with Video interactions for Medicare Advantage patients:
- Select Medical Decision Making.
- Calculate Code
- Select the 1st position Modifier field.
- Select the Modifier 95 option.
Click Submit Code.
Fee for Service - Medicare
Medicare Fee for Service patients require both Telephonic and Video interaction. When Finalizing the visit:
- Choose Medical Decision Making.
- Calculate Code.
- Choose Modifier 95 from 1st position.
- Submit Code.
Fee for Service - Commercial
Interactions with Fee for Service Commercial members can be both Telephonic only and Telephonic with video.
To Finalize Telephone Only interactions for Fee for Service Commercial members:
- Select from the Telephone Only list.
- Submit Code.
Keep in mind that the Medical Decision Making is not required for Manually selected codes.
To Finalize Telephonic with Video interactions for Fee for Service Commercial members:
- Choose Medical Decision Making.
- Calculate Code
- Choose the 95 Modifier code from the 1st position.
- Submit Code.
