BC Advantage - 2020 Issue 3
Physicians Assistants and Telehealth/Telemedicine
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Article Overview
This article reviews Medicare telehealth and telemedicine guidance with a focus on who may furnish services, how claims are reported, and what documentation is expected. It is aimed at providers, billers, and compliance staff who need a general understanding of telehealth payment rules, Medicare processing references, and related billing considerations.
Why This Topic Matters
Telehealth billing depends on careful attention to provider eligibility, claim formatting, site reporting, and payer-specific guidance. Understanding the article helps readers recognize which broad Medicare telehealth topics are addressed before reviewing the full guidance.
Article Sections
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Provider eligibility and CMS guidance
Discusses the general topic of which types of providers may furnish telehealth services and the importance of wording in CMS guidance.
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Billing guidelines
Covers Medicare telehealth billing concepts, eligible services, and references to fee schedule and annual updates.
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Professional fee claims
Addresses how telehealth professional claims are reported, including place of service reporting and related claim-processing considerations.
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Originating site claims
Reviews originating site facility fee reporting and payment concepts for telehealth encounters.
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Case example
Provides a general telehealth encounter scenario illustrating distant site and originating site claim reporting.
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Documentation requirements
Summarizes the documentation themes associated with telehealth services and the role of MAC and payer guidance.
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Telehealth resources for providers
Lists supporting Medicare and professional resources related to telehealth policy and administration.
What You Will Learn
- How Medicare telehealth guidance addresses provider eligibility and service settings
- How telehealth services are generally reported on claims
- What broad documentation elements are associated with telehealth encounters
- Which Medicare resources and manuals are referenced for telehealth guidance
Who Should Read This
- Physicians and other clinicians
- Physician assistants and advanced practice providers
- Medical coders and billers
- Revenue cycle and compliance staff
Codes Discussed
Modifiers Discussed
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