January 26, 2017
New changes are coming for coding of telehealth/telemedicine services. These new changes have been added to the Telehealth/Telemedicine Services payment policy.
New Modifier: Effective with dates of service January 1, 2017, the American Medical Association (AMA) has created a new modifier for telemedicine services. The new modifier states:
Modifier 95 - Synchronous Telemedicine Service Rendered via a Real-time Audio and Video Telecommunications System: “Synchronous telemedicine service is defined as real-time interaction between a physician or other qualified healthcare professional and a patient who is located at the distant site from the physician or other qualified healthcare professional. The totality of the communication of information exchanged between the physician or other qualified healthcare professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that would be sufficient to meet the key components and requirements of the same service when rendered via a face to face interaction.” (“CPT 2017 Standard,” AMA)
The codes that can be submitted with modifier 95 are identified in Appendix P in the CPT code book and marked with a star in the body of the code book.
New Place of Service Code: Effective January 1, 2017, the Centers for Medicare and Medicaid Services (CMS) has created a new place of service (POS) code for telehealth services:
02 - Telehealth: The location where health services and health related services are provided or received, through telecommunication technology.
This new POS code should be used by the physician or other qualified healthcare professional furnishing telehealth services from a distant site. This POS code would not apply to originating site facilities billing a facility fee (billed as code Q3014).