{"id":5128,"date":"2018-02-17T16:26:16","date_gmt":"2018-02-17T16:26:16","guid":{"rendered":"http:\/\/tele.healthcare\/?p=5128"},"modified":"2018-02-17T16:26:16","modified_gmt":"2018-02-17T16:26:16","slug":"medicare-learning-network-telehealth-services-fact-sheet-2018","status":"publish","type":"post","link":"https:\/\/drmiltie.com\/at-home-testing\/medicare-learning-network-telehealth-services-fact-sheet-2018\/","title":{"rendered":"Medicare Learning Network &#8211; Telehealth Services Fact Sheet &#8211; 2018"},"content":{"rendered":"<p><strong>[pdf-embedder url=&#8221;https:\/\/mtelehealth.com\/wp-content\/uploads\/2018\/06\/Medicare-Learning-Network-Telehealth-Services-Fact-Sheet-2018.pdf&#8221; title=&#8221;Medicare Learning Network &#8211; Telehealth Services Fact Sheet &#8211; 2018&#8243;]Services offered via telehealth and the corresponding HCPCS\/CPT code to use for reimbursement.\u00a0<\/strong><\/p>\n<p>February 18, 2018 by Center for Medicare and Medicaid Services<\/p>\n<p>TELEHEALTH SERVICES<\/p>\n<p>TABLE OF CONTENTS<\/p>\n<p>Originating Sites&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;. 2<\/p>\n<p><a href=\"https:\/\/d.docs.live.net\/009a608cb869c213\/mTelehealth\/Marketing\/Telehealth%20Studies%20and%20Materials\/Medicare%20Learning%20Network%20-%20Telehealth%20Services%20Fact%20Sheet%20-%202018.docx#_TOC_250005\">Distant Site Practitioners&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;.. 3<\/a><\/p>\n<p><a href=\"https:\/\/d.docs.live.net\/009a608cb869c213\/mTelehealth\/Marketing\/Telehealth%20Studies%20and%20Materials\/Medicare%20Learning%20Network%20-%20Telehealth%20Services%20Fact%20Sheet%20-%202018.docx#_TOC_250004\">Telehealth Services&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;. 3<\/a><\/p>\n<p><a href=\"https:\/\/d.docs.live.net\/009a608cb869c213\/mTelehealth\/Marketing\/Telehealth%20Studies%20and%20Materials\/Medicare%20Learning%20Network%20-%20Telehealth%20Services%20Fact%20Sheet%20-%202018.docx#_TOC_250003\">Billing and Payment for Professional Services Furnished Via Telehealth&#8230;&#8230;&#8230;&#8230;&#8230;&#8230; 7<\/a><\/p>\n<p><a href=\"https:\/\/d.docs.live.net\/009a608cb869c213\/mTelehealth\/Marketing\/Telehealth%20Studies%20and%20Materials\/Medicare%20Learning%20Network%20-%20Telehealth%20Services%20Fact%20Sheet%20-%202018.docx#_TOC_250002\">Billing and Payment for the Originating Site Facility Fee&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230; 8<\/a><\/p>\n<p><a href=\"https:\/\/d.docs.live.net\/009a608cb869c213\/mTelehealth\/Marketing\/Telehealth%20Studies%20and%20Materials\/Medicare%20Learning%20Network%20-%20Telehealth%20Services%20Fact%20Sheet%20-%202018.docx#_TOC_250001\">Resources&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;.. 8<\/a><\/p>\n<p><a href=\"https:\/\/d.docs.live.net\/009a608cb869c213\/mTelehealth\/Marketing\/Telehealth%20Studies%20and%20Materials\/Medicare%20Learning%20Network%20-%20Telehealth%20Services%20Fact%20Sheet%20-%202018.docx#_TOC_250000\">Helpful Websites&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230; 9<\/a><\/p>\n<p>Regional Office Rural Health Coordinators. 10<\/p>\n<p>CPT codes, descriptions and other data only are copyright 2017American Medical Association. All Rights Reserved. Applicable FARS\/HHSAR apply. CPT is a registered trademark of the American Medical Association.Applicable FARS\/HHSAR Restrictions Apply to Government Use. Fee schedules, relative value units, conversion factors and\/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use.<\/p>\n<p>The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.<\/p>\n<p>Learn about these calendar year (CY) 2018 Medicare telehealth services topics:<\/p>\n<ul>\n<li>Originating sites<\/li>\n<li>Distant site practitioners<\/li>\n<li>Telehealth services<\/li>\n<li>Billing and payment for professional services furnished via telehealth<\/li>\n<li>Billing and payment for the originating site facility fee<\/li>\n<li>Resources<\/li>\n<li>Lists of helpful websites and Regional Office Rural Health Coordinators<\/li>\n<\/ul>\n<p>When we use &#8220;you&#8221; in this publication, we are referring to physicians or practitioners at the distant site.<\/p>\n<p>Medicare pays for a limited number of Part B services furnished by a physician or practitioner to an eligible beneficiary via a telecommunications system. For eligible telehealth services, the use of a telecommunications system substitutes for an in-person encounter.<\/p>\n<p>&nbsp;<\/p>\n<p><strong>ORIGINATING SITES<\/strong><\/p>\n<p>An originating site is the location of an eligible Medicare beneficiary at the time the service furnished via a telecommunications system occurs. Medicare beneficiaries are eligible for telehealth services only if they are presented from an originating site located in:<\/p>\n<ul>\n<li>A county outside of a Metropolitan Statistical Area (MSA) or<\/li>\n<li>A rural Health Professional Shortage Area (HPSA) located in a rural census tract<\/li>\n<\/ul>\n<p>The Health Resources and Services Administration (HRSA) determines HPSAs, and the Census Bureau determines MSAs. You can access HRSA&#8217;s Medicare Telehealth Payment Eligibility Analyzer to determine a potential originating site&#8217;s eligibility for Medicare telehealth payment.<\/p>\n<p>Entities that participate in a Federal telemedicine demonstration project approved by (or receiving funding from) the Secretary of the U.S. Department of Health &amp; Human Services as of<\/p>\n<p>December 31, 2000, qualify as originating sites regardless of geographic location.<\/p>\n<p>Each CY, the geographic eligibility of an originating site is established based on the status of the area as of December 31st of the prior CY. Such eligibility continues for the full CY.<\/p>\n<p>The originating sites authorized by law are:<\/p>\n<ul>\n<li>The offices of physicians or practitioners<\/li>\n<li>Hospitals<\/li>\n<li>Critical Access Hospitals (CAHs)<\/li>\n<li>Rural Health Clinics<\/li>\n<li>Federally Qualified Health Centers<\/li>\n<li>Hospital-based or CAH-based Renal Dialysis Centers (including satellites)<\/li>\n<li>Skilled Nursing Facilities (SNFs) and<\/li>\n<li>Community Mental Health Centers (CMHCs)<\/li>\n<\/ul>\n<p>Note:\u00a0\u00a0\u00a0 Independent Renal Dialysis Facilities are not eligible originating sites.<\/p>\n<p>&nbsp;<\/p>\n<h1><a name=\"_TOC_250005\"><\/a>DISTANT SITE PRACTITIONERS<\/h1>\n<p>Practitioners at the distant site who may furnish and receive payment for covered telehealth services (subject to State law) are:<\/p>\n<ul>\n<li>Physician<\/li>\n<li>Nurse practitioners (NPs).<\/li>\n<li>Physician assistants (PAs).<\/li>\n<li>Nurse-midwives.<\/li>\n<li>Clinical nurse specialists (CNSs).<\/li>\n<li>Certified registered nurse<\/li>\n<li>Clinical psychologists (CPs) and clinical social workers (CSWs). CPs and CSWs cannot bill for psychiatric diagnostic interview examinations with medical services or medical evaluation and management services under Medi These practitioners may not bill or receive payment for Current Procedural Terminology (CPT) codes 90792, 90833, 90836, and 90838.<\/li>\n<li>Registered dietitians or nutrition<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h1><a name=\"_TOC_250004\"><\/a>TELEHEALTH SERVICES<\/h1>\n<p>As a condition of payment, you must use an interactive audio and video telecommunications system that permits real-time communication between you, at the distant site, and the beneficiary, at the originating site. Asynchronous &#8220;store and forward&#8221; technology, the transmission of medical information the physician or practitioner at the distant site reviews at a later time, is permitted only in Federal telemedicine demonstration programs in Alaska or Hawaii.<\/p>\n<p>CY 2018 Medicare Telehealth Services<\/p>\n<p>&nbsp;<\/p>\n<table>\n<tbody>\n<tr>\n<td width=\"432\">Service<\/td>\n<td width=\"288\">HCPCS\/CPT Code<\/td>\n<\/tr>\n<tr>\n<td width=\"432\">Telehealth consultations, emergency department or initial inpatient<\/td>\n<td width=\"288\">HCPCS codes G0425-G0427<\/td>\n<\/tr>\n<tr>\n<td width=\"432\">Follow-up inpatient telehealth consultations furnished to beneficiaries in hospitals or SNFs<\/td>\n<td width=\"288\">HCPCS codes G0406-G0408<\/td>\n<\/tr>\n<tr>\n<td width=\"432\">Office or other outpatient visits<\/td>\n<td width=\"288\">CPT codes 99201-99215<\/td>\n<\/tr>\n<tr>\n<td width=\"432\">Subsequent hospital care services, with the limitation of 1 telehealth visit every 3 days<\/td>\n<td width=\"288\">CPT codes 99231-99233<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>&nbsp;<\/p>\n<p>CPT only copyright 2017American Medical Association. All rights reserved.<\/p>\n<p>CY 2018 Medicare Telehealth Services (cont.)<\/p>\n<p>&nbsp;<\/p>\n<table>\n<tbody>\n<tr>\n<td width=\"432\">Service<\/td>\n<td width=\"288\">HCPCS\/CPT Code<\/td>\n<\/tr>\n<tr>\n<td width=\"432\">Subsequent nursing facility care services, with the limitation of 1 telehealth visit every 30 days<\/td>\n<td width=\"288\">CPT codes 99307-99310<\/td>\n<\/tr>\n<tr>\n<td width=\"432\">Individual and group kidney disease education services<\/td>\n<td width=\"288\">HCPCS codes G0420 and G0421<\/td>\n<\/tr>\n<tr>\n<td width=\"432\">Individual and group diabetes self-management training services, with a minimum of 1 hour of in-person instruction to be furnished in the initial year training period to ensure effective injection training<\/td>\n<td width=\"288\">HCPCS codes G0108 and G0109<\/td>\n<\/tr>\n<tr>\n<td width=\"432\">Individual and group health and behavior assessment and intervention<\/td>\n<td width=\"288\">CPT codes 96150-96154<\/td>\n<\/tr>\n<tr>\n<td width=\"432\">Individual psychotherapy<\/td>\n<td width=\"288\">CPT codes 90832-90834 and<\/p>\n<p>90836-90838<\/td>\n<\/tr>\n<tr>\n<td width=\"432\">Telehealth Pharmacologic Management<\/td>\n<td width=\"288\">HCPCS code G0459<\/td>\n<\/tr>\n<tr>\n<td width=\"432\">Psychiatric diagnostic interview examination<\/td>\n<td width=\"288\">CPT codes 90791 and 90792<\/td>\n<\/tr>\n<tr>\n<td width=\"432\">End-Stage Renal Disease (ESRD)-related services included in the monthly capitation payment<\/td>\n<td width=\"288\">CPT codes 90951, 90952, 90954,<\/p>\n<p>90955, 90957, 90958, 90960, and<\/p>\n<p>90961<\/td>\n<\/tr>\n<tr>\n<td width=\"432\">End-Stage Renal Disease (ESRD)-related services for home dialysis per full month, for patients younger than<\/p>\n<p>2 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents<\/td>\n<td width=\"288\">CPT code 90963<\/td>\n<\/tr>\n<tr>\n<td width=\"432\">End-Stage Renal Disease (ESRD)-related services for home dialysis per full month, for patients 2-11 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents<\/td>\n<td width=\"288\">CPT code 90964<\/td>\n<\/tr>\n<tr>\n<td width=\"432\">End-Stage Renal Disease (ESRD)-related services for home dialysis per full month, for patients 12-19 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents<\/td>\n<td width=\"288\">CPT code 90965<\/td>\n<\/tr>\n<tr>\n<td width=\"432\">End-Stage Renal Disease (ESRD)-related services for home dialysis per full month, for patients 20 years of age and older<\/td>\n<td width=\"288\">CPT code 90966<\/td>\n<\/tr>\n<tr>\n<td width=\"432\">End-Stage Renal Disease (ESRD)-related services for dialysis less than a full month of service, per day; for patients younger than 2 years of age (effective for services furnished on and after January 1, 2017)<\/td>\n<td width=\"288\">CPT code 90967<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>CPT only copyright 2017American Medical Association. All rights reserved.<\/p>\n<p>CY 2018 Medicare Telehealth Services (cont.)<\/p>\n<p>&nbsp;<\/p>\n<table>\n<tbody>\n<tr>\n<td width=\"432\">Service<\/td>\n<td width=\"288\">HCPCS\/CPT Code<\/td>\n<\/tr>\n<tr>\n<td width=\"432\">End-Stage Renal Disease (ESRD)-related services for dialysis less than a full month of service, per day; for patients 2-11 years of age (effective for services furnished on and after January 1, 2017)<\/td>\n<td width=\"288\">CPT code 90968<\/td>\n<\/tr>\n<tr>\n<td width=\"432\">End-Stage Renal Disease (ESRD)-related services for dialysis less than a full month of service, per day; for patients 12-19 years of age (effective for services furnished on and after January 1, 2017)<\/td>\n<td width=\"288\">CPT code 90969<\/td>\n<\/tr>\n<tr>\n<td width=\"432\">End-Stage Renal Disease (ESRD)-related services for dialysis less than a full month of service, per day; for patients 20 years of age and older (effective for services furnished on and after January 1, 2017)<\/td>\n<td width=\"288\">CPT code 90970<\/td>\n<\/tr>\n<tr>\n<td width=\"432\">Individual and group medical nutrition therapy<\/td>\n<td width=\"288\">HCPCS code G0270 and CPT codes 97802-97804<\/td>\n<\/tr>\n<tr>\n<td width=\"432\">Neurobehavioral status examination<\/td>\n<td width=\"288\">CPT code 96116<\/td>\n<\/tr>\n<tr>\n<td width=\"432\">Smoking cessation services<\/td>\n<td width=\"288\">HCPCS codes G0436 and G0437 and CPT codes 99406 and 99407<\/td>\n<\/tr>\n<tr>\n<td width=\"432\">Alcohol and\/or substance (other than tobacco) abuse structured assessment and intervention services<\/td>\n<td width=\"288\">HCPCS codes G0396 and G0397<\/td>\n<\/tr>\n<tr>\n<td width=\"432\">Annual alcohol misuse screening, 15 minutes<\/td>\n<td width=\"288\">HCPCS code G0442<\/td>\n<\/tr>\n<tr>\n<td width=\"432\">Brief face-to-face behavioral counseling for alcohol misuse, 15 minutes<\/td>\n<td width=\"288\">HCPCS code G0443<\/td>\n<\/tr>\n<tr>\n<td width=\"432\">Annual depression screening, 15 minutes<\/td>\n<td width=\"288\">HCPCS code G0444<\/td>\n<\/tr>\n<tr>\n<td width=\"432\">High-intensity behavioral counseling to prevent sexually transmitted infection; face-to-face, individual, includes: education, skills training and guidance on how to change sexual behavior; performed semi-annually, 30 minutes<\/td>\n<td width=\"288\">HCPCS code G0445<\/td>\n<\/tr>\n<tr>\n<td width=\"432\">Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes<\/td>\n<td width=\"288\">HCPCS code G0446<\/td>\n<\/tr>\n<tr>\n<td width=\"432\">Face-to-face behavioral counseling for obesity, 15 minutes<\/td>\n<td width=\"288\">HCPCS code G0447<\/td>\n<\/tr>\n<tr>\n<td width=\"432\">Transitional care management services with moderate medical decision complexity (face-to-face visit within 14 days of discharge)<\/td>\n<td width=\"288\">CPT code 99495<\/td>\n<\/tr>\n<tr>\n<td width=\"432\">Transitional care management services with high medical decision complexity (face-to-face visit within 7 days of discharge)<\/td>\n<td width=\"288\">CPT code 99496<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>CPT only copyright 2017American Medical Association. All rights reserved.<\/p>\n<p>CY 2018 Medicare Telehealth Services (cont.)<\/p>\n<table>\n<tbody>\n<tr>\n<td width=\"432\">Service<\/td>\n<td width=\"288\">HCPCS\/CPT Code<\/td>\n<\/tr>\n<tr>\n<td width=\"432\">Advance Care Planning, 30 minutes (effective for services furnished on and after January 1, 2017)<\/td>\n<td width=\"288\">CPT code 99497<\/td>\n<\/tr>\n<tr>\n<td width=\"432\">Advance Care Planning, additional 30 minutes (effective for services furnished on and after January 1, 2017)<\/td>\n<td width=\"288\">CPT code 99498<\/td>\n<\/tr>\n<tr>\n<td width=\"432\">Psychoanalysis<\/td>\n<td width=\"288\">CPT code 90845<\/td>\n<\/tr>\n<tr>\n<td width=\"432\">Family psychotherapy (without the patient present)<\/td>\n<td width=\"288\">CPT code 90846<\/td>\n<\/tr>\n<tr>\n<td width=\"432\">Family psychotherapy (conjoint psychotherapy) (with patient present)<\/td>\n<td width=\"288\">CPT code 90847<\/td>\n<\/tr>\n<tr>\n<td width=\"432\">Prolonged service in the office or other outpatient setting requiring direct patient contact beyond the usual service; first hour<\/td>\n<td width=\"288\">CPT code 99354<\/td>\n<\/tr>\n<tr>\n<td width=\"432\">Prolonged service in the office or other outpatient setting requiring direct patient contact beyond the usual service; each additional 30 minutes<\/td>\n<td width=\"288\">CPT code 99355<\/td>\n<\/tr>\n<tr>\n<td width=\"432\">Prolonged service in the inpatient or observation setting requiring uniUfloor time beyond the usual service; first hour (list separately in addition to code for inpatient evaluation and management service)<\/td>\n<td width=\"288\">CPT code 99356<\/td>\n<\/tr>\n<tr>\n<td width=\"432\">Prolonged service in the inpatient or observation setting requiring uniUfloor time beyond the usual service; each additional 30 minutes (list separately in addition to code for prolonged service)<\/td>\n<td width=\"288\">CPT code 99357<\/td>\n<\/tr>\n<tr>\n<td width=\"432\">Annual Wellness Visit, includes a personalized prevention plan of service (PPPS) first visit<\/td>\n<td width=\"288\">HCPCS code G0438<\/td>\n<\/tr>\n<tr>\n<td width=\"432\">Annual Wellness Visit, includes a personalized prevention plan of service (PPPS) subsequent visit<\/td>\n<td width=\"288\">HCPCS code G0439<\/td>\n<\/tr>\n<tr>\n<td width=\"432\">Telehealth Consultation, Critical Care, initial, physicians typically spend 60 minutes communicating with the patient and providers via telehealth (effective for services furnished on and after January 1, 2017)<\/td>\n<td width=\"288\">HCPCS code G0508<\/td>\n<\/tr>\n<tr>\n<td width=\"432\">Telehealth Consultation, Critical Care, subsequent, physicians typically spend 50 minutes communicating with the patient and providers via telehealth (effective for services furnished on and after January 1, 2017)<\/td>\n<td width=\"288\">HCPCS code G0509<\/td>\n<\/tr>\n<tr>\n<td width=\"432\">Counseling visit to discuss need for lung cancer screening using low dose CT scan (LDCT) (service is for eligibility determination and shared decision making (effective for services furnished on and after January 1, 2018)<\/td>\n<td width=\"288\">HCPCS code G0296<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>CPT only copyright 2017American Medical Association. All rights reserved.<\/p>\n<p>CY 2018 Medicare Telehealth Services (cont.)<\/p>\n<p>&nbsp;<\/p>\n<table>\n<tbody>\n<tr>\n<td width=\"432\">Service<\/td>\n<td width=\"288\">HCPCS\/CPT Code<\/td>\n<\/tr>\n<tr>\n<td width=\"432\">Interactive Complexity Psychiatry Services and Procedures (effective for services furnished on and after January 1, 2018)<\/td>\n<td width=\"288\">CPT code 90785<\/td>\n<\/tr>\n<tr>\n<td width=\"432\">Health Risk Assessment (effective for services furnished on and after January 1, 2018)<\/td>\n<td width=\"288\">CPT codes 96160 and 96161<\/td>\n<\/tr>\n<tr>\n<td width=\"432\">Comprehensive assessment of and care planning for patients requiring chronic care management (effective for services furnished on and after January 1, 2018)<\/td>\n<td width=\"288\">HCPCS code G0506<\/td>\n<\/tr>\n<tr>\n<td width=\"432\">Psychotherapy for crisis (effective for services furnished on and after January 1, 2018)<\/td>\n<td width=\"288\">CPT codes 90839 and 90840<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>&nbsp;<\/p>\n<p>For ESRD-related services, a physician, NP, PA, or CNS must furnish at least one &#8220;hands-on&#8221; visit (not telehealth) each month to examine the vascular access site.<\/p>\n<h1><a name=\"_TOC_250003\"><\/a>BILLING AND PAYMENT FOR PROFESSIONAL SERVICES FURNISHED VIA TELEHEALTH<\/h1>\n<p>Submit claims for telehealth services using the appropriate CPT or HCPCS code for the professional service.<\/p>\n<p>For Federal telemedicine demonstration programs in Alaska or Hawaii, submit claims using the appropriate CPT or HCPCS code for the professional service along with the telehealth modifier GQ<\/p>\n<p>if you performed telehealth services &#8220;via an asynchronous telecommunications system&#8221; (for example, 99201 GQ).By coding and billing the GQ modifier, you are certifying that the asynchronous medical file was collected and transmitted to you at the distant site from a Federal telemedicine demonstration project conducted in Alaska or Hawaii.<\/p>\n<p>For professional services furnished on or after January 1, 2017, to indicate that the billed service was furnished as a telehealth service from a distant site, submit claims for telehealth services using Place of Service (POS) 02: Telehealth: The location where health services and health-related services are provided or received, through telehealth telecommunication technology.As of January 1, 2018, distant site practitioners billing telehealth services under the CAH Optional Payment Method submit institutional claims using the GT modifier.<\/p>\n<p>You should bill the Medicare Administrative Contractor (MAC) for covered telehealth services. Medicare pays you the appropriate amount under the Medicare Physician Fee Schedule (PFS) for telehealth services. When you are located in a CAH and reassigned your billing rights to a CAH that elected the Optional Payment Method, the CAH bills the MAC for telehealth services, and the payment amount is 80 percent of the Medicare PFS for telehealth services.<\/p>\n<p>CPT only copyright 2017American Medical Association. All rights reserved.<\/p>\n<h1><a name=\"_TOC_250002\"><\/a>BILLING AND PAYMENT FOR THE ORIGINATING SITE FACILITY FEE<\/h1>\n<p>Originating sites are paid an originating site facility fee for telehealth services as described by HCPCS code 03014. Bill the MAC for the originating site facility fee, which is a separately billable Part B payment.<\/p>\n<p>Note:\u00a0\u00a0\u00a0 When a CMHC serves as an originating site, the originating site facility fee does not count toward the number of services used to determine payment for partial hospitalization services.<\/p>\n<h1><a name=\"_TOC_250001\"><\/a>RESOURCES<\/h1>\n<p>Telehealth Services Resources<\/p>\n<p>&nbsp;<\/p>\n<table>\n<tbody>\n<tr>\n<td width=\"288\">For More Information About&#8230;<\/td>\n<td width=\"432\">Resource<\/td>\n<\/tr>\n<tr>\n<td width=\"288\">Telehealth Services<\/td>\n<td width=\"432\">CMS.gov\/Medicare\/Medicare-General-Information\/ Telehealth<\/p>\n<p>Chapter 12 of the Medicare Claims Processing Manual<\/p>\n<p>{Publication 100-04)<\/td>\n<\/tr>\n<tr>\n<td width=\"288\">Physician Bonuses<\/td>\n<td width=\"432\">CMS.gov\/Medicare\/Medicare-Fee-for-Service-PaymenU HPSAPSAPhysicianBonuses<\/p>\n<p>Health Professional Shortage Area Physician Bonus Program<\/td>\n<\/tr>\n<tr>\n<td width=\"288\">All Available MLN Products<\/td>\n<td width=\"432\">MLN Catalog<\/td>\n<\/tr>\n<tr>\n<td width=\"288\">Medicare Information for Beneficiaries<\/td>\n<td width=\"432\">Medicare.9ov<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>&nbsp;<\/p>\n<p>Hyperlink Table<\/p>\n<p>&nbsp;<\/p>\n<table>\n<tbody>\n<tr>\n<td width=\"288\">Embedded Hyperlink<\/td>\n<td width=\"432\">Complete URL<\/td>\n<\/tr>\n<tr>\n<td width=\"288\">Health Professional Shortage Area<\/td>\n<td width=\"432\">https:<a href=\"http:\/\/www.cms.gov\/Medicare\/Medicare-Fee-for-Service-\">\/\/www.cms.gov\/Medicare\/Medicare-Fee-for-Service-<\/a> PamenUHPSAPSAPhsicianBonuses\/i \u00a0ndex.html<\/td>\n<\/tr>\n<tr>\n<td width=\"288\">Medicare Telehealth Payment Eligibility Analyzer<\/td>\n<td width=\"432\"><a href=\"https:\/\/datawarehouse\">https:\/\/datawarehouse<\/a>.\u00a0 \u00a0hrsa.gov\/tools\/analyzers\/geo\/ Telehealth.aspx<\/td>\n<\/tr>\n<tr>\n<td width=\"288\">Medicare Claims Processing Manual<\/td>\n<td width=\"432\">https:<a href=\"http:\/\/www.cms.gov\/Regulations-and-Guidance\/Guidance\/\">\/\/www.cms.gov\/Regulations-and-Guidance\/Guidance\/<\/a> Manuals\/Downloads\/elm104c12.pdf<\/td>\n<\/tr>\n<tr>\n<td width=\"288\">Health Professional Shortage Area Physician Bonus Program<\/td>\n<td width=\"432\">https:<a href=\"http:\/\/www.cms.gov\/Outreach-and-Education\/Medi\">\/\/www.cms.gov\/Outreach-and-Education\/Medi<\/a> \u00a0care- Learning-Network-MLN\/MLNProducts\/Down \u00a0loads\/ HPSAfctsht.pdf<\/td>\n<\/tr>\n<tr>\n<td width=\"288\">MLN Catalog<\/td>\n<td width=\"432\">https:<a href=\"http:\/\/www.cms.gov\/Outreach-and-Education\/Medi\">\/\/www.cms.gov\/Outreach-and-Education\/Medi<\/a> \u00a0care- Learning-Network-MLN\/MLNProducts\/Down \u00a0loads\/ MLNCatalog.pdf<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>&nbsp;<\/p>\n<h1><a name=\"_TOC_250000\"><\/a>HELPFUL WEBSITES<\/h1>\n<h2>American Hospital Association Rural Health Care<\/h2>\n<p>https:<a href=\"http:\/\/www.aha.org\/advocacy\/small-or-rural\">\/\/www.aha.org\/advocacy\/small-or-rural<\/a><\/p>\n<h2>Critical Access Hospitals Center<\/h2>\n<p>https:<a href=\"http:\/\/www.cms.gov\/Center\/Provid\">\/\/www.cms.gov\/Center\/Provid<\/a>er-Type\/Critical-Access-Hospitals-Center.html<\/p>\n<h2>Disproportionate Share Hospitals<\/h2>\n<p>https:<a href=\"http:\/\/www.cms.gov\/Medicare\/Medicare-Fee-for-Service-Payment\/Acutel\">\/\/www.cms.gov\/Medicare\/Medicare-Fee-for-Service-Payment\/Acutel<\/a>npatientPPS\/dsh.html<\/p>\n<h2>Federally Qualified Health Centers Center<\/h2>\n<p>https:<a href=\"http:\/\/www.cms.gov\/Center\/Provid\">\/\/www.cms.gov\/Center\/Provid<\/a>er-Type\/Federally-Qualified-Health-Centers-FQHC-Center\u00a0\u00a0 \u00a0.html<\/p>\n<h2>Health Resources and Services Administration<\/h2>\n<p>https:<a href=\"http:\/\/www.hrsa.gov\/\">\/\/www.hrsa.gov<\/a><\/p>\n<h2>HospitalCenter<\/h2>\n<p>https:<a href=\"http:\/\/www.cms.gov\/Center\/Provid\">\/\/www.cms.gov\/Center\/Provid<\/a>er-Type\/Hospital-Center\u00a0 \u00a0.html<\/p>\n<h2>Medicare Learning Network\u00ae<\/h2>\n<p><a href=\"http:\/\/go.cms.gov\/MLNGenlnfo\">http:\/\/go.cms.gov\/MLNGenlnfo<\/a><\/p>\n<h2>NationalAssociation of Community Health Centers<\/h2>\n<p><a href=\"http:\/\/www.nachc\">http:\/\/www.nachc<\/a>. org<\/p>\n<h2>NationalAssociation of Rural Health Clinics<\/h2>\n<p><a href=\"https:\/\/narhc.org\">https:\/\/narhc.org<\/a><\/p>\n<h2>NationalRuralHealth Association<\/h2>\n<p>https:<a href=\"http:\/\/www.ruralhealthweb.org\/\">\/\/www.ruralhealthweb.org<\/a><\/p>\n<h2>Rural Health Clinics Center<\/h2>\n<p>https:<a href=\"http:\/\/www.cms.gov\/Center\/Provid\">\/\/www.cms.gov\/Center\/Provid<\/a>er-Type\/Rural-Health-Clinics-Center.html<\/p>\n<h2>Rural Health Information Hub<\/h2>\n<p>https:<a href=\"http:\/\/www.ruralhealthinfo.org\/\">\/\/www.ruralhealthinfo.org<\/a><\/p>\n<h2>Swing Bed Providers<\/h2>\n<p>https:<a href=\"http:\/\/www.cms.gov\/Medicare\/Medicare-Fee-for-Service-Payment\/SN\">\/\/www.cms.gov\/Medicare\/Medicare-Fee-for-Service-Payment\/SN<\/a>FPPS\/SwingBed.html<\/p>\n<h3>Telehealth<\/h3>\n<p>https:<a href=\"http:\/\/www.cms.gov\/Medicare\/Medicare-General-lnformati\">\/\/www.cms.gov\/Medicare\/Medicare-General-lnformati<\/a>\u00a0\u00a0 \u00a0on\/Telehealth<\/p>\n<h3>Telehealth Resource Centers<\/h3>\n<p><a href=\"https:\/\/www.telehealthresourcecenter.org\">https:\/\/www.telehealthresourcecenter.org<\/a><\/p>\n<h3>U.S. Census Bureau<\/h3>\n<p>https:<a href=\"http:\/\/www.census.gov\/\">\/\/www.census.gov<\/a><\/p>\n<p><strong>REGIONAL OFFICE RURAL HEALTH COORDINATORS<\/strong><\/p>\n<p>To find contact information for CMS Regional Office Rural Health Coordinators who provide technical, policy, and operational assistance on rural health issues, refer to CMS.gov\/Outreach-and-Education\/ Outreach\/OpenDoorForums\/Down\u00a0 \u00a0loads\/CMSRuralHeal \u00a0thCoordinators.pdf.<\/p>\n<p>&nbsp;<\/p>\n<p>https:\/\/www.cms.gov\/Outreach-and-Education\/Medicare-Learning-Network-MLN\/MLNProducts\/downloads\/TelehealthSrvcsfctsht.pdf<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>[pdf-embedder url=&#8221;https:\/\/mtelehealth.com\/wp-content\/uploads\/2018\/06\/Medicare-Learning-Network-Telehealth-Services-Fact-Sheet-2018.pdf&#8221; title=&#8221;Medicare Learning Network &#8211; Telehealth Services Fact Sheet &#8211; 2018&#8243;]Services offered via telehealth [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":5129,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_uag_custom_page_level_css":"","_uf_show_specific_survey":0,"_uf_disable_surveys":false,"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center 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