Commonwealth Care Alliance has updated the Telemedicine-Telehealth payment policy and the billing and coding guidelines for services provided via telemedicine/telehealth (e.g., interactive audio-video, interactive audio only).
Reminder: Accurately document both the
- Place of Service (POS) code and
- appropriate modifier.
Aligned with the Centers for Medicare & Medicaid Services (CMS) current descriptions, the CCA Place of Service (POS) code attests to the accurate location of the member during the provided service.
|Place of Service Code||Place of Service Name||Place of Service Description||Examples of the Patient’s Location|
|02||Telehealth Provided Other Than in a Patient’s Home||The location where health services and health related services are provided or received, through telecommunication technology. Patient is not located in their home when receiving health services or health-related services through telecommunication technology.||Hospital Medical Facility Medical Office|
|10||Telehealth Provided in Patient’s Home||The location where health services and health related services are provided or received, through telecommunication technology. Patient is located in their home (which is a location other than a hospital or other facility where the patient receives care in a private residence) when receiving health services or health-related services through telecommunication technology.||Patient’s Home Patient’s Car Private, Non-medical Location|
Available modifiers include:
|95||Synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system|
|GT||Via audio & video telecommunications systems|
|G0||Telehealth services for diagnosis or treatment of symptoms of an acute stroke|
|GQ||Via asynchronous telemedicine|
|FQ||Service furnished using audio-only communication technology|
For additional information, review the Telemedicine-Telehealth Payment Policy