Monthly Archives

March 2018

MedPAC recommends ‘measured approach’ to Medicare telehealth coverage

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Article Author: Evan Sweeney

Source: Fierce Healthcare

Without a consistent comparison from commercial insurers, federal policymakers should adopt a “measured approach” to incorporating telehealth coverage into the Medicare program, according to the Medicare Payment Advisory Commission (MedPAC).

In a new report (PDF) mandated under the 21st Century Cures Act, the advisory organization shied away from recommending the Centers for Medicare & Medicaid Services (CMS) expand coverage for certain telehealth services, and instead urged policymakers to evaluate emerging modalities based on the ability to lower costs, improve access and drive quality care.

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Telehealth Billing Compliance: Medicare Says Goodbye to the GT Modifier

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Article Author: Nathaniel M. Lacktman

Source: Health Care Law Today

For over a decade, Medicare has required providers to append special modifiers to their CPT and HCPCS codes when billing for telehealth services. The two primary modifiers for telehealth services were GT (indicating the service was delivered via an interactive audio and video telecommunications system) and GQ (indicating the service was delivered via an asynchronous telecommunications system). Effective January 1, 2018 that has changed because CMS has decided to largely eliminate the requirement to use the GT modifier on telehealth claims.

Instead of using the GT modifier, providers must mark their telehealth services claims with “Place of Service (POS) 02.” A POS code is required on professional claims for all services – telehealth or otherwise – and using POS 02 signals to Medicare that the service was provided via telehealth. Previously, providers were instructed to use the POS code for where the patient was located at the time of the service. Effective January 1, 2018, POS 02 is to be used for all telehealth services under Medicare. The introduction of POS 02 rendered it unnecessary to also require the distant site practitioner report the GT modifier on the claim.

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