Medicare Compliance & Reimbursement - 2021 Issue 3
Telehealth Services: Master Telehealth Coding with 10 Facts from the Experts
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Article Overview
This article summarizes guidance from Medicare Part B MAC representatives on telehealth and related billing issues during the COVID-19 public health emergency. It is aimed at providers and coders who need to understand current telehealth documentation, place-of-service handling, phone-based services, and other Medicare reimbursement topics discussed in a webinar format.
Why This Topic Matters
Telehealth billing rules changed rapidly during the public health emergency, and this article helps readers gauge whether the topic applies to their Medicare Part B workflows. It is especially relevant for practices handling virtual visits, telephone encounters, and documentation requirements under pandemic-era guidance.
Article Sections
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Don’t Forget These PHE-Related Basics
General reminders about telehealth billing and documentation during the public health emergency. The section focuses on broad Medicare telehealth practices and related recordkeeping expectations.
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Can the GE Modifier Allow Residents to Report Phone Codes?
A question-and-answer discussion about resident involvement in telephone-based services and teaching-physician context during the public health emergency.
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Can You Differentiate 99441 Series From 98966 Range?
Guidance comparing telephone service code sets for different practitioner types during the public health emergency. The section addresses how billing patterns may differ across provider categories.
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Will Practices Eventually Return to Pre-PHE Rules?
Discussion of how telehealth policy may change after the public health emergency ends. The section provides general context on post-PHE regulatory expectations.
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Should You Resubmit Claims That Are Missing Modifier 95?
A billing and claims-processing question about telehealth claims during the public health emergency. The section covers whether corrections or resubmissions may be needed in a general sense.
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Should You Report 99211 for Specimen Collections?
A coding question about specimen collection services in a Part B clinic setting. The section discusses how to think about billing in the context of COVID-19 testing workflows.
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Can You Determine the POS for an Emergency Department Service?
A place-of-service question about emergency department services delivered via telehealth. The section explains the relevance of service location for billing purposes.
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How Should You Document Time in 2021?
Documentation guidance for time-based services in the 2021 environment. The section focuses on general time documentation expectations and audit visibility.
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Are Telehealth Patients Then Considered ‘Established?’
A discussion of patient status classification after telehealth encounters during the public health emergency. The section addresses how telehealth may affect later office-visit categorization.
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Can Practices Report Prolonged Service Codes for Phone Calls?
A coding question about prolonged services in connection with telephone evaluation and management encounters. The section covers how broader E/M time concepts intersect with phone-based care.
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Are Asymptomatic Screenings Billable?
A final question-and-answer item about screening for COVID-19 exposure in asymptomatic patients. The section addresses whether such services may be reported in Medicare billing.
What You Will Learn
- How Medicare Part B telehealth guidance changed during the COVID-19 public health emergency
- What kinds of documentation are emphasized for virtual encounters
- How telephone-based services and related practitioner types are discussed in the article
- How place of service, time reporting, and patient status questions arise in telehealth billing
- What general categories of claims and screening issues are addressed in the webinar Q&A
Who Should Read This
- Medical coders
- Billing staff
- Revenue cycle teams
- Physician practices
- Telehealth providers
- Medicare Part B providers
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
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