Telemedicine Billing CPT Codes: A Reference Guide

As shelter in place orders begin to lift in cities and states throughout America, there is more of a spotlight on the medical community than ever before. The spread of COVID-19 and its effect on healthcare systems means that now, more than ever, doctors, nurses and physician assistants must focus on their patients’ health and well-being, instead of operational tasks like billing and coding.

Outsourcing the revenue cycle management process for your practice is time and money well spent. However, it’s crucial you work with a company that knows what it’s doing. Here at Med USA, we have more than three decades of experience in the medical billing field. Our team of highly-trained experts knows exactly what it takes to speed up the billing process, ensuring revenue continues to flow.

With fewer and fewer people visiting the doctor in person, it’s also important that you implement telemedicine at your practice. Telemedicine ensures your most vulnerable patients receive the care they need without unnecessary exposure to illness in your waiting room or medical facility. Unfortunately, there’s some complexity regarding telemedicine reimbursement. both commercial payers and CMS have been slow to enact policies around telemedicine reimbursement. But COVID-19 has made that a priority.

COVID-19 and the rise of new medical codes

Did you know that some states and payers reimburse for telehealth at the same rate as in-person visits? Or that you can provide telehealth services no matter where a patient is located geographically? If not, you aren’t alone. These are two of several developments that have occurred due to the COVID-19 pandemic.

In the past, telemedicine was coded and billed differently than an in-person visit. If you were working with an inexperienced company, this could lead to errors on a claim and potentially a denial of payment from an insurance company. When you partner with Med USA, there’s nothing to worry about. Our experienced billers are well aware of the new telemedicine mandates and know exactly what it takes to file claims exactly as. required. This means less stress for you. It also means you can focus more on your patients.

Each type of medical visit requires a unique billing process. Once a billing department determines the guidelines from a particular insurance company, they’re then required to find the right CPT code. These codes were traditionally used. for office and outpatient visits, but they can now be utilized for telemedicine visits as well. Coverage for telemedicine services depends on a patients’ insurance policy. This means billers must be aware of specific codes when filing payments.

CPT codes and Medicare

While selecting and documenting the correct CPT codes is vital, there is an additional facet to be aware of –– Medicare billing. In most cases, services provided to Medicare patients require the addition of a modifier at the end of a specific CPT code. The modifier depends on the type of telecommunication technology used for the visit, whether video chat or strictly over the phone.

Other modifiers to be aware of

Medicare services aren’t the only ones that require modifiers for proper reimbursement. Private payers have different modifiers based on the type of telecommunication technology used and CMS claims require the use of a “place of service” code.

If you aren’t an experienced medical coder, these modifiers can be incredibly difficult to understand. Plus, one wrong code can mean waiting for weeks or months to receive payment. Without prompt payment, you lose income, and running a medical practice without cashflow just isn’t possible.

Your medical practice needs a qualified billing partner

The last few months have changed the world of medicine significantly. Now, more than ever, it’s important you know how to code and bill telemedicine services correctly. Feeling stressed? It’s okay! To assist you in the transition, we’ve created a helpful guide to telemedicine billing. Once you’re finished reading it, you’ll have a much better idea of what steps to take next.

With more than four decades of building profitable relationships, our services are based on the concept of adaptability. We provide solutions for office-based​ physician practices, hospital-based practices and medical billing companies with services that are easy to implement and use. In addition, we provide scalable solutions for all types of providers, from small practices to large healthcare systems.

We aren’t just puffing ourselves up, either. Over three case studies performed on practices and health organizations of varying sizes, Med USA reduced time in accounts receivable by nearly 40%. In addition, one study showed 94% of charts closed on the same day, while another showed 98% of cases were billed within 24 hours.

If you need to partner with a medical billing and practice management company that you can trust, you’ve come to the right place. Our team provides a variety of customized solutions including an integrated electronic health record (EHR) system, medical coding and credentialing services. Get in touch with us today and find out more about how we can work together and help your revenues increase.