AHA Coding Clinic® for HCPCS - 2019 Issue 3; Introduction
Introduction to coding telehealth services
Telehealth is a growing component of the digital transformation in healthcare. Facilities are utilizing telehealth to fill in the gaps in care especially in areas where there is limited or no access to care and/or access to certain specialties. It is also a useful tool for managing chronic illnesses, a point of access for urgent care and emergencies, and patient education to name a few of the areas where telehealth is growing. While access to care is greatly expanded for patients in underserved areas, it also offers the convenience of providing greater access to healthcare in general, including in...
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Article Overview
This article explains the general scope of telehealth, common delivery modalities, and the coding references used to report telehealth-related services. It is useful for coders, billers, compliance staff, and clinicians who need a high-level orientation to telehealth reporting across CPT and HCPCS Level II, along with references to Medicare-related telehealth service categories and payer/state considerations.
Why This Topic Matters
Telehealth reporting depends on service type, platform, payer requirements, and applicable code set guidance. Understanding the article helps readers recognize the broad categories of telehealth services and the coding references that may affect documentation and claim reporting.
Article Sections
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Telehealth overview and growth
Introduces telehealth as a growing part of healthcare delivery and summarizes the broad reasons it is being adopted. It also notes general access and operational factors associated with telehealth expansion.
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Definitions and telehealth modalities
Provides general definitions used to describe telehealth delivery settings and major communication modalities. The section also points to external resources for additional reference.
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State regulations and payer requirements
Discusses the need to consider state-level rules and payer-specific requirements before reporting telehealth services. It highlights compliance and legal review as part of the process.
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CPT coding
Covers the CPT coding framework for telehealth reporting and identifies related codebook references. It includes a broad set of service categories associated with telehealth billing.
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HCPCS level II codes
Summarizes HCPCS Level II telehealth-related reporting concepts, including facility and place-of-service considerations. It also lists Medicare-oriented telehealth service categories and related code references.
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Additional resources and closing
Provides a brief closing note and points readers to external organizational resources for additional telehealth information.
What You Will Learn
- How telehealth is broadly defined and used in healthcare delivery
- The major telehealth modalities and terminology commonly encountered in coding
- Which code sets and references are relevant to telehealth reporting
- The kinds of telehealth-related service categories discussed for CPT and HCPCS Level II
- Why payer and state requirements matter for telehealth claims
Who Should Read This
- Medical coders
- Billers and revenue cycle staff
- Compliance professionals
- Health information management professionals
- Clinicians involved in telehealth documentation
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
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