Telemedicine services / Eligible sites and providers

Subscribe or sign in to view the full article.

Note:  The following article synopsis was NOT provided by HCPro. It was created by Find-A-Code/innoviHealth.

Article Overview

This article covers Medicare telehealth eligibility at the originating and distant sites, the types of facilities and practitioners involved, and the basic billing elements associated with telemedicine services. It is intended for coders, billing staff, and compliance personnel who need a high-level understanding of Medicare telehealth site requirements and claim reporting concepts.

Why This Topic Matters

Telehealth billing depends on where the patient is located, what type of facility is involved, and which practitioners may furnish the service. Understanding these eligibility and claim-reporting basics helps support accurate Medicare claims processing and policy compliance.

Article Sections

  1. Originating site eligibility

    Discusses the general Medicare telehealth location requirements for the patient and the types of facilities that may serve in this role. Also notes a limited exception tied to certain federal telemedicine participation.

  2. Originating site billing

    Covers the facility fee billing concept associated with the originating site and related Medicare claims processing guidance.

  3. Distant site practitioners and claims

    Summarizes the practitioner categories that may furnish telehealth services from the distant site and the claim reporting element referenced for telehealth services.

  4. Payment considerations

    Describes general reimbursement and patient liability concepts for professional services furnished by the distant site practitioner.

What You Will Learn

  • The Medicare framework for telehealth originating and distant site participation
  • Which types of facilities are discussed as eligible telehealth sites
  • Which practitioner groups are discussed as eligible telehealth providers
  • The basic billing and claims reporting elements referenced for telehealth services
  • General payment and beneficiary cost-sharing concepts for telemedicine services

Who Should Read This

  • Medical coders
  • Billing staff
  • Revenue cycle teams
  • Compliance professionals
  • Telehealth program administrators

Codes Discussed

Modifiers Discussed


Subscribe or sign in to view the full article.

Official DecisionHealth® Newsletter Archives includes:

  • Includes over 25,000 articles from:
    • Coder Pink Sheets
    • Part B News
    • Answer Books newsletters
  • Current newsletters added each quarter
  • Timely news and guidance vital for your practice
  • Fully searchable through Find-A-Code's Comprehensive Search
  • Codes mentioned in articles are linked to the Find-A-Code Code Information pages
  • Code Information pages link back to related articles
  • Save yourself tons of research time, find everything in one place!
Access to this feature is available in the following products:
  • DecisionHealth Coding, Billing and Compliance Library

Related Articles

Articles are listed in order of calculated relevance.

demo
request yours today
subscribe
start today
newsletter
free subscription

Thank you for choosing Find-A-Code, please Sign In to remove ads.

Aimee- AI -powered coding assistant - Try it now for Free Would you like Aimee - AI
to help you with this?