{"id":26749,"date":"2020-03-25T05:46:06","date_gmt":"2020-03-25T05:46:06","guid":{"rendered":"https:\/\/dev.mtelehealth.com\/?p=26749"},"modified":"2020-03-25T05:46:06","modified_gmt":"2020-03-25T05:46:06","slug":"the-center-for-medicaid-and-medicare-services-cms-2020-medicare-learning-network-telehealth-services-booklet","status":"publish","type":"post","link":"https:\/\/drmiltie.com\/at-home-testing\/the-center-for-medicaid-and-medicare-services-cms-2020-medicare-learning-network-telehealth-services-booklet\/","title":{"rendered":"The Center for Medicaid and Medicare Services (CMS) – 2020 Medicare Learning Network Telehealth Services Booklet"},"content":{"rendered":"\n
Download PDF<\/a><\/div>\n\n\n\n

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Download Printer-friendly PDF<\/a><\/div>\n\n\n\n

<\/p>\n\n\n\n

MLN Booklet<\/p>\n\n\n\n

TELEHEALTH SERVICES<\/strong><\/p>\n\n\n\n

ICN MLN901705 March 2020<\/p>\n\n\n\n

Target Audience: <\/strong>Medicare Fee-For-Service Providers<\/p>\n\n\n\n

The Hyperlink Table, at the end of this document, provides the complete URL for each hyperlink.<\/p>\n\n\n\n

TABLE OF CONTENTS<\/strong><\/p>\n\n\n\n

Originating Sites………………………………………………………………………………………………………………….. 3<\/strong><\/p>\n\n\n\n

Distant Site Practitioners……………………………………………………………………………………………………… 4<\/strong><\/p>\n\n\n\n

Telehealth Services……………………………………………………………………………………………………………… 4<\/strong><\/p>\n\n\n\n

Telehealth Services Billing and Payment………………………………………………………………………………. 7<\/strong><\/p>\n\n\n\n

Telehealth Originating Sites Billing and Payment………………………………………………………………….. 8<\/strong><\/p>\n\n\n\n

Resources…………………………………………………………………………………………………………………………… 8<\/strong><\/p>\n\n\n\n

Helpful Websites………………………………………………………………………………………………………………….. 9<\/strong><\/p>\n\n\n\n

Regional Office Rural Health Coordinators…………………………………………………………………………… 9<\/strong><\/p>\n\n\n\n

CPT codes, descriptions and other data only are copyright 2018 American Medical Association. All Rights Reserved.<\/p>\n\n\n\n

Applicable FARS\/HHSAR apply. CPT is a registered trademark of the American Medical Association. Applicable FARS\/<\/p>\n\n\n\n

HHSAR Restrictions Apply to Government Use. Fee schedules, relative value units, conversion factors and\/or related<\/p>\n\n\n\n

components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA<\/p>\n\n\n\n

does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data<\/p>\n\n\n\n

contained or not contained herein.<\/p>\n\n\n\n

Page 1 of 9<\/p>\n\n\n\n

Telehealth Services MLN Booklet<\/p>\n\n\n\n

Page 2 of 9 ICN MLN901705 March 2020<\/p>\n\n\n\n

CMS Alert!<\/strong><\/p>\n\n\n\n

Medicare Beneficiaries Expanded Telehealth Benefits During COVID-19 Outbreak<\/strong><\/p>\n\n\n\n

Under the Coronavirus Preparedness and Response Supplemental Appropriations Act<\/p>\n\n\n\n

and Section 1135 waiver authority, the Centers for Medicare & Medicaid Services (CMS)<\/p>\n\n\n\n

broadened access to Medicare telehealth services, so beneficiaries can get a wider range of<\/p>\n\n\n\n

services from their doctors and other clinicians without traveling to a health care facility. On<\/p>\n\n\n\n

March 6, 2020, Medicare began temporarily paying clinicians to furnish beneficiary telehealth<\/p>\n\n\n\n

services residing across the entire country.<\/p>\n\n\n\n

Before this announcement, Medicare could only pay clinicians for telehealth services, such<\/p>\n\n\n\n

as routine visits in certain circumstances. For example, the beneficiary getting the services<\/p>\n\n\n\n

must live in a rural area and travel to a local medical facility to get telehealth services from<\/p>\n\n\n\n

a doctor in a remote location. In addition, the beneficiary generally could not get telehealth<\/p>\n\n\n\n

services in their home.<\/p>\n\n\n\n

Under this Section 1135 waiver expansion, a range of providers, such as doctors, nurse<\/p>\n\n\n\n

practitioners, clinical psychologists, and licensed clinical social workers, can offer a<\/p>\n\n\n\n

specific set of telehealth services. The specific set of services beneficiaries can get include<\/p>\n\n\n\n

evaluation and management visits (common office visits), mental health counseling, and<\/p>\n\n\n\n

preventive health screenings. Beneficiaries can get telehealth services in any health care<\/p>\n\n\n\n

facility including a physician\u2019s office, hospital, nursing home or rural health clinic, as well<\/p>\n\n\n\n

as from their homes. This change broadens telehealth flexibility without regard to the<\/p>\n\n\n\n

beneficiary\u2019s diagnosis, because at this critical point it is important to ensure beneficiaries<\/p>\n\n\n\n

follow CDC guidance including practicing social distancing to reduce the risk of COVID-19<\/p>\n\n\n\n

transmission. This change will help prevent vulnerable beneficiaries from unnecessarily<\/p>\n\n\n\n

entering a health care facility when clinicians can meet their needs remotely.<\/p>\n\n\n\n

To read the Fact Sheet on this announcement visit: https:\/\/www.cms.gov\/newsroom\/factsheets\/<\/p>\n\n\n\n

medicare-telemedicine-health-care-provider-fact-sheet<\/p>\n\n\n\n

To read the Frequently Asked Questions on this announcement visit: https:\/\/www.cms.gov\/<\/p>\n\n\n\n

files\/document\/medicare-telehealth-frequently-asked-questions-faqs-31720.pdf<\/p>\n\n\n\n

Telehealth Services MLN Booklet<\/p>\n\n\n\n

Learn about these Medicare telehealth services topics:<\/p>\n\n\n\n

\u25cf\u25cf Originating sites<\/p>\n\n\n\n

\u25cf\u25cf Distant site practitioners<\/p>\n\n\n\n

\u25cf\u25cf Telehealth services<\/p>\n\n\n\n

\u25cf\u25cf Telehealth services billing and payment<\/p>\n\n\n\n

\u25cf\u25cf Telehealth originating sites billing and payment<\/p>\n\n\n\n

\u25cf\u25cf Resources<\/p>\n\n\n\n

\u25cf\u25cf Helpful websites and Regional Office Rural Health Coordinators<\/p>\n\n\n\n

Medicare pays for specific (Part B) physician or practitioner services furnished through a<\/p>\n\n\n\n

telecommunications system. Telehealth services substitute for an in-person encounter.<\/p>\n\n\n\n

ORIGINATING SITES<\/strong><\/p>\n\n\n\n

An originating site is the location where a Medicare beneficiary gets physician or practitioner medical<\/p>\n\n\n\n

services through a telecommunications system. The beneficiary must go to the originating site for the<\/p>\n\n\n\n

services located in either:<\/p>\n\n\n\n

\u25cf\u25cf A county outside a Metropolitan Statistical Area (MSA)<\/p>\n\n\n\n

\u25cf\u25cf A rural Health Professional Shortage Area (HPSA) in a rural census tract<\/p>\n\n\n\n

The Health Resources and Services Administration (HRSA) decides HPSAs, and the Census Bureau<\/p>\n\n\n\n

decides MSAs. To see a potential Medicare telehealth originating site\u2019s payment eligibility, go to<\/p>\n\n\n\n

HRSA\u2019s Medicare Telehealth Payment Eligibility Analyzer.<\/p>\n\n\n\n

Providers qualify as originating sites, regardless of location, if they were participating in a Federal<\/p>\n\n\n\n

telemedicine demonstration project approved by (or getting funding from) the U.S. Department of<\/p>\n\n\n\n

Health & Human Services as of December 31, 2000.<\/p>\n\n\n\n

Beginning July 1, 2019, the<\/p>\n\n\n\n

Substance Use-Disorder Prevention<\/p>\n\n\n\n

that Promotes Opioid Recovery and<\/p>\n\n\n\n

Treatment (SUPPORT) for Patients<\/p>\n\n\n\n

and Communities Act removes<\/p>\n\n\n\n

the originating site geographic<\/p>\n\n\n\n

conditions and adds an individual\u2019s<\/p>\n\n\n\n

home as a permissible originating<\/p>\n\n\n\n

telehealth services site for treatment<\/p>\n\n\n\n

of a substance use disorder or a<\/p>\n\n\n\n

co-occurring mental health disorder.<\/p>\n\n\n\n

Each December 31 of the prior calendar year (CY),<\/p>\n\n\n\n

an originating site\u2019s geographic eligibility is based on<\/p>\n\n\n\n

the area\u2019s status. This eligibility continues for a full CY.<\/p>\n\n\n\n

Authorized originating sites include:<\/p>\n\n\n\n

\u25cf\u25cf Physician and practitioner offices<\/p>\n\n\n\n

\u25cf\u25cf Hospitals<\/p>\n\n\n\n

\u25cf\u25cf Critical Access Hospitals (CAHs)<\/p>\n\n\n\n

\u25cf\u25cf Rural Health Clinics<\/p>\n\n\n\n

\u25cf\u25cf Federally Qualified Health Centers<\/p>\n\n\n\n

\u25cf\u25cf Hospital-based or CAH-based Renal Dialysis<\/p>\n\n\n\n

Centers (including satellites)<\/p>\n\n\n\n

\u25cf\u25cf Skilled Nursing Facilities (SNFs)<\/p>\n\n\n\n

\u25cf\u25cf Community Mental Health Centers (CMHCs)<\/p>\n\n\n\n

Page 3 of 9 ICN MLN901705 March 2020<\/p>\n\n\n\n

Telehealth Services MLN Booklet<\/p>\n\n\n\n

\u25cf\u25cf Renal Dialysis Facilities<\/p>\n\n\n\n

\u25cf\u25cf Homes of beneficiaries with End-Stage Renal Disease<\/p>\n\n\n\n

(ESRD) getting home dialysis<\/p>\n\n\n\n

\u25cf\u25cf Mobile Stroke Units<\/p>\n\n\n\n

Note: <\/strong>Medicare does not apply originating site geographic<\/p>\n\n\n\n

conditions to hospital-based and CAH-based<\/p>\n\n\n\n

renal dialysis centers, renal dialysis facilities, and<\/p>\n\n\n\n

beneficiary homes when practitioners furnish monthly<\/p>\n\n\n\n

home dialysis ESRD-related medical evaluations.<\/p>\n\n\n\n

Independent Renal Dialysis Facilities are not eligible<\/p>\n\n\n\n

originating sites.<\/p>\n\n\n\n

Beginning January 1, 2019, the<\/p>\n\n\n\n

Bipartisan Budget Act of 2018<\/p>\n\n\n\n

removed the originating site<\/p>\n\n\n\n

geographic conditions and added<\/p>\n\n\n\n

eligible originating sites to diagnose,<\/p>\n\n\n\n

evaluate, or treat symptoms of an<\/p>\n\n\n\n

acute stroke. Go to MLN Matters\u00ae<\/p>\n\n\n\n

article, New Modifier for Expanding<\/p>\n\n\n\n

the Use of Telehealth for Individuals<\/p>\n\n\n\n

with Stroke to learn how to use the<\/p>\n\n\n\n

new modifier for billing.<\/p>\n\n\n\n

DISTANT SITE PRACTITIONERS<\/strong><\/p>\n\n\n\n

Distant site practitioners who can furnish and get payment for covered telehealth services (subject to<\/p>\n\n\n\n

State law) are:<\/p>\n\n\n\n

\u25cf\u25cf Physicians<\/p>\n\n\n\n

\u25cf\u25cf Nurse practitioners (NPs)<\/p>\n\n\n\n

\u25cf\u25cf Physician assistants (PAs)<\/p>\n\n\n\n

\u25cf\u25cf Nurse-midwives<\/p>\n\n\n\n

\u25cf\u25cf Clinical nurse specialists (CNSs)<\/p>\n\n\n\n

\u25cf\u25cf Certified registered nurse anesthetists<\/p>\n\n\n\n

\u25cf\u25cf Clinical psychologists (CPs) and clinical social workers (CSWs)<\/p>\n\n\n\n

o CPs and CSWs cannot bill Medicare for psychiatric diagnostic interview examinations with<\/p>\n\n\n\n

medical services or medical evaluation and management services. They cannot bill or get paid<\/p>\n\n\n\n

for Current Procedural Terminology (CPT) codes 90792, 90833, 90836, and 90838.<\/p>\n\n\n\n

\u25cf\u25cf Registered dietitians or nutrition professional<\/p>\n\n\n\n

TELEHEALTH SERVICES<\/strong><\/p>\n\n\n\n

You must use an interactive audio and video telecommunications system that permits real-time<\/p>\n\n\n\n

communication between you at the distant site, and the beneficiary at the originating site.<\/p>\n\n\n\n

Transmitting medical information to a physician or practitioner who reviews it later is permitted only in<\/p>\n\n\n\n

Alaska or Hawaii Federal telemedicine demonstration programs.<\/p>\n\n\n\n

CPT only copyright 2018 American Medical Association. All rights reserved.<\/p>\n\n\n\n

Page 4 of 9 ICN MLN901705 March 2020<\/p>\n\n\n\n

Telehealth Services MLN Booklet<\/p>\n\n\n\n

CY 2019 Medicare Telehealth Services<\/strong><\/p>\n\n\n\n

Service HCPCS\/CPT Code<\/strong><\/p>\n\n\n\n

Telehealth consultations, emergency department or initial inpatient G0425\u2013G0427<\/p>\n\n\n\n

Follow-up inpatient telehealth consultations furnished to<\/p>\n\n\n\n

beneficiaries in hospitals or SNFs<\/p>\n\n\n\n

G0406\u2013G0408<\/p>\n\n\n\n

Office or other outpatient visits 99201\u201399215<\/p>\n\n\n\n

Subsequent hospital care services, with the limitation of 1 telehealth<\/p>\n\n\n\n

visit every 3 days<\/p>\n\n\n\n

99231\u201399233<\/p>\n\n\n\n

Subsequent nursing facility care services, with the limitation of<\/p>\n\n\n\n

1 telehealth visit every 30 days<\/p>\n\n\n\n

99307\u201399310<\/p>\n\n\n\n

Individual and group kidney disease education services G0420\u2013G0421<\/p>\n\n\n\n

Individual and group diabetes self-management training services,<\/p>\n\n\n\n

with a minimum of 1 hour of in-person instruction furnished in the<\/p>\n\n\n\n

initial year training period to ensure effective injection training<\/p>\n\n\n\n

G0108\u2013G0109<\/p>\n\n\n\n

Individual and group health and behavior assessment<\/p>\n\n\n\n

and intervention<\/p>\n\n\n\n

96150\u201396154<\/p>\n\n\n\n

Individual psychotherapy 90832\u201390838<\/p>\n\n\n\n

Telehealth Pharmacologic Management G0459<\/p>\n\n\n\n

Psychiatric diagnostic interview examination 90791\u201390792<\/p>\n\n\n\n

End-Stage Renal Disease (ESRD)-related services included in the<\/p>\n\n\n\n

monthly capitation payment<\/p>\n\n\n\n

90951, 90952, 90954, 90955,<\/p>\n\n\n\n

90957, 90958, 90960, 90961<\/p>\n\n\n\n

End-Stage Renal Disease (ESRD)-related services for home dialysis<\/p>\n\n\n\n

per full month, for patients younger than 2 years of age to include<\/p>\n\n\n\n

monitoring for the adequacy of nutrition, assessment of growth and<\/p>\n\n\n\n

development, and counseling of parents<\/p>\n\n\n\n

90963<\/p>\n\n\n\n

End-Stage Renal Disease (ESRD)-related services for home<\/p>\n\n\n\n

dialysis per full month, for patients 2\u201311 years of age to include<\/p>\n\n\n\n

monitoring for the adequacy of nutrition, assessment of growth<\/p>\n\n\n\n

and development, and counseling of parents<\/p>\n\n\n\n

90964<\/p>\n\n\n\n

End-Stage Renal Disease (ESRD)-related services for home<\/p>\n\n\n\n

dialysis per full month, for patients 12\u201319 years of age to include<\/p>\n\n\n\n

monitoring for the adequacy of nutrition, assessment of growth<\/p>\n\n\n\n

and development, and counseling of parents<\/p>\n\n\n\n

90965<\/p>\n\n\n\n

End-Stage Renal Disease (ESRD)-related services for home dialysis<\/p>\n\n\n\n

per full month, for patients 20 years of age and older<\/p>\n\n\n\n

90966<\/p>\n\n\n\n

End-Stage Renal Disease (ESRD)-related services for dialysis<\/p>\n\n\n\n

less than a full month of service, per day; for patients younger than<\/p>\n\n\n\n

2 years of age<\/p>\n\n\n\n

90967<\/p>\n\n\n\n

End-Stage Renal Disease (ESRD)-related services for dialysis less<\/p>\n\n\n\n

than a full month of service, per day; for patients 2\u201311 years of age<\/p>\n\n\n\n

90968<\/p>\n\n\n\n

CPT only copyright 2018 American Medical Association. All rights reserved.<\/p>\n\n\n\n

Page 5 of 9 ICN MLN901705 March 2020<\/p>\n\n\n\n

Telehealth Services MLN Booklet<\/p>\n\n\n\n

CY 2019 Medicare Telehealth Services (cont.)<\/strong><\/p>\n\n\n\n

Service HCPCS\/CPT Code<\/strong><\/p>\n\n\n\n

End-Stage Renal Disease (ESRD)-related services for dialysis less<\/p>\n\n\n\n

than a full month of service, per day; for patients 12\u201319 years of age<\/p>\n\n\n\n

90969<\/p>\n\n\n\n

End-Stage Renal Disease (ESRD)-related services for dialysis less than<\/p>\n\n\n\n

a full month of service, per day; for patients 20 years of age and older<\/p>\n\n\n\n

90970<\/p>\n\n\n\n

Individual and group medical nutrition therapy G0270, 97802\u201397804<\/p>\n\n\n\n

Neurobehavioral status examination 96116<\/p>\n\n\n\n

Smoking cessation services G0436, G0437, 99406, 99407<\/p>\n\n\n\n

Alcohol and\/or substance (other than tobacco) abuse structured<\/p>\n\n\n\n

assessment and intervention services<\/p>\n\n\n\n

G0396, G0397<\/p>\n\n\n\n

Annual alcohol misuse screening, 15 minutes G0442<\/p>\n\n\n\n

Brief face-to-face behavioral counseling for alcohol misuse,<\/p>\n\n\n\n

15 minutes<\/p>\n\n\n\n

G0443<\/p>\n\n\n\n

Annual depression screening, 15 minutes G0444<\/p>\n\n\n\n

High-intensity behavioral counseling to prevent sexually transmitted<\/p>\n\n\n\n

infection; face-to-face, individual, includes: education, skills training<\/p>\n\n\n\n

and guidance on how to change sexual behavior; performed<\/p>\n\n\n\n

semi-annually, 30 minutes<\/p>\n\n\n\n

G0445<\/p>\n\n\n\n

Annual, face-to-face intensive behavioral therapy for cardiovascular<\/p>\n\n\n\n

disease, individual, 15 minutes<\/p>\n\n\n\n

G0446<\/p>\n\n\n\n

Face-to-face behavioral counseling for obesity, 15 minutes G0447<\/p>\n\n\n\n

Transitional care management services with moderate medical<\/p>\n\n\n\n

decision complexity (face-to-face visit within 14 days of discharge)<\/p>\n\n\n\n

99495<\/p>\n\n\n\n

Transitional care management services with high medical decision<\/p>\n\n\n\n

complexity (face-to-face visit within 7 days of discharge)<\/p>\n\n\n\n

99496<\/p>\n\n\n\n

Advance Care Planning, 30 minutes 99497<\/p>\n\n\n\n

Advance Care Planning, additional 30 minutes 99498<\/p>\n\n\n\n

Psychoanalysis 90845<\/p>\n\n\n\n

Family psychotherapy (without the patient present) 90846<\/p>\n\n\n\n

Family psychotherapy (conjoint psychotherapy) (with patient present) 90847<\/p>\n\n\n\n

Prolonged service in the office or other outpatient setting requiring<\/p>\n\n\n\n

direct patient contact beyond the usual service; first hour<\/p>\n\n\n\n

99354<\/p>\n\n\n\n

Prolonged service in the office or other outpatient setting requiring direct<\/p>\n\n\n\n

patient contact beyond the usual service; each additional 30 minutes<\/p>\n\n\n\n

99355<\/p>\n\n\n\n

Prolonged service in the inpatient or observation setting requiring<\/p>\n\n\n\n

unit\/floor time beyond the usual service; first hour (list separately in<\/p>\n\n\n\n

addition to code for inpatient evaluation and management service)<\/p>\n\n\n\n

99356<\/p>\n\n\n\n

CPT only copyright 2018 American Medical Association. All rights reserved.<\/p>\n\n\n\n

Page 6 of 9 ICN MLN901705 March 2020<\/p>\n\n\n\n

Telehealth Services MLN Booklet<\/p>\n\n\n\n

CY 2019 Medicare Telehealth Services (cont.)<\/strong><\/p>\n\n\n\n

Service HCPCS\/CPT Code<\/strong><\/p>\n\n\n\n

Prolonged service in the inpatient or observation setting requiring<\/p>\n\n\n\n

unit\/floor time beyond the usual service; each additional 30 minutes<\/p>\n\n\n\n

(list separately in addition to code for prolonged service)<\/p>\n\n\n\n

99357<\/p>\n\n\n\n

Annual Wellness Visit, includes a personalized prevention plan of<\/p>\n\n\n\n

service (PPPS) first visit<\/p>\n\n\n\n

G0438<\/p>\n\n\n\n

Annual Wellness Visit, includes a personalized prevention plan of<\/p>\n\n\n\n

service (PPPS) subsequent visit<\/p>\n\n\n\n

G0439<\/p>\n\n\n\n

Telehealth Consultation, Critical Care, initial, physicians typically<\/p>\n\n\n\n

spend 60 minutes communicating with the patient and providers<\/p>\n\n\n\n

via telehealth<\/p>\n\n\n\n

G0508<\/p>\n\n\n\n

Telehealth Consultation, Critical Care, subsequent, physicians<\/p>\n\n\n\n

typically spend 50 minutes communicating with the patient and<\/p>\n\n\n\n

providers via telehealth<\/p>\n\n\n\n

G0509<\/p>\n\n\n\n

Counseling visit to discuss need for lung cancer screening using<\/p>\n\n\n\n

low dose CT scan (LDCT) (service is for eligibility determination<\/p>\n\n\n\n

and shared decision making<\/p>\n\n\n\n

G0296<\/p>\n\n\n\n

Interactive Complexity Psychiatry Services and Procedures 90785<\/p>\n\n\n\n

Health Risk Assessment 96160, 96161<\/p>\n\n\n\n

Comprehensive assessment of and care planning for patients<\/p>\n\n\n\n

requiring chronic care management<\/p>\n\n\n\n

G0506<\/p>\n\n\n\n

Psychotherapy for crisis 90839, 90840<\/p>\n\n\n\n

Prolonged preventive services G0513, G0514<\/p>\n\n\n\n

A physician, NP, PA, or CNS must furnish at least one ESRD-related \u201chands on visit\u201d (not telehealth)<\/p>\n\n\n\n

each month to examine the beneficiary\u2019s vascular access site.<\/p>\n\n\n\n

TELEHEALTH SERVICES BILLING AND PAYMENT<\/strong><\/p>\n\n\n\n

Submit professional telehealth service claims using the appropriate CPT or HCPCS code.<\/p>\n\n\n\n

If you performed telehealth services \u201cthrough an asynchronous telecommunications system\u201d, add the<\/p>\n\n\n\n

telehealth GQ modifier with the professional service CPT or HCPCS code (for example, 99201 GQ).<\/p>\n\n\n\n

You are certifying the asynchronous medical file was collected and transmitted to you at the distant<\/p>\n\n\n\n

site from a Federal telemedicine demonstration project conducted in Alaska or Hawaii.<\/p>\n\n\n\n

Submit telehealth services claims, using Place of Service (POS) 02-Telehealth, to indicate you<\/p>\n\n\n\n

furnished the billed service as a professional telehealth service from a distant site. As of January 1,<\/p>\n\n\n\n

2018, distant site practitioners billing telehealth services under the CAH Optional Payment Method II<\/p>\n\n\n\n

must submit institutional claims using the GT modifier.<\/p>\n\n\n\n

CPT only copyright 2018 American Medical Association. All rights reserved.<\/p>\n\n\n\n

Page 7 of 9 ICN MLN901705 March 2020<\/p>\n\n\n\n

Telehealth Services MLN Booklet<\/p>\n\n\n\n

Bill covered telehealth services to your Medicare Administrative Contractor (MAC). They pay you the<\/p>\n\n\n\n

appropriate telehealth services amount under the Medicare Physician Fee Schedule (PFS). If you are<\/p>\n\n\n\n

located in, and you reassigned your billing rights to, a CAH and elected the Optional Payment Method<\/p>\n\n\n\n

II for outpatients, the CAH bills the telehealth services to the MAC. The payment is 80 percent of the<\/p>\n\n\n\n

Medicare PFS facility amount for the distant site service.<\/p>\n\n\n\n

TELEHEALTH ORIGINATING SITES BILLING AND PAYMENT<\/strong><\/p>\n\n\n\n

HCPCS Code Q3014 describes the Medicare telehealth originating sites facility fee. Bill your MAC for<\/p>\n\n\n\n

the separately billable Part B originating site facility fee.<\/p>\n\n\n\n

Note: <\/strong>The originating site facility fee does not count toward the number of services used to determine<\/p>\n\n\n\n

payment for partial hospitalization services when a CMHC serves as an originating site.<\/p>\n\n\n\n

RESOURCES<\/strong><\/p>\n\n\n\n

Telehealth Services Resources<\/strong><\/p>\n\n\n\n

For More Information About\u2026 Resource<\/strong><\/p>\n\n\n\n

Telehealth Services CMS.gov\/Medicare\/Medicare-General-Information\/Telehealth\/<\/p>\n\n\n\n

Telehealth-Codes.html<\/p>\n\n\n\n

CMS.gov\/Medicare\/Medicare-General-Information\/Telehealth<\/p>\n\n\n\n

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Physician Bonuses CMS.gov\/Medicare\/Medicare-Fee-for-Service-Payment\/<\/p>\n\n\n\n

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American Hospital Association Rural<\/strong><\/p>\n\n\n\n

Health Care<\/strong><\/p>\n\n\n\n

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