The national public health emergency (PHE) has been extended to April 15th, 2022, but that doesn't mean that telehealth is going to be billed and paid the same as the past year and a half. Here are some of the changes that are coming:
Medicare will require the usage of the new place of service code 10 (telehealth services provided to a patient who is in their home) or 02 (telehealth provided 0ther than in patient’s home) as of April 4, 2022. However, Medicare is only covering telehealth where the originating site is the patient's home during the PHE. Once the PHE is over, unless Congress enacts legislation to remove the originating site mandate, telehealth will no longer be covered using POS code 10.
Cigna and Blue Cross will start requiring the usage of the place of service code where the patient would have been seen- i.e. 11 for office, 21 for inpatient- instead of using 02 place of service as of 4/1/22. They also want the 95 modifier in place of GT.
Blue Cross of MA will now require the provider to be licensed in the state in which the patient is located. There will be no more cross-state line leniency on coverage.
As insurances release new requirements and policy changes, we will update our blog accordingly. For more information regarding telehealth billing, contact us today.
Premier Medical Billing, LLC
617-958-6502
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