UPDATE: Billing for E-visits & Telehealth

UPDATE AS OF MARCH 31, 2020

UPDATES AS OF MARCH 23, 2020

The updates below are current as of March 20, 2020.

Under the current situation, changes are rapidly being made to the way in which telehealth and e-visits are billed.  We will continue to provide updates as new facts present:

  1. E-visits (G2061-G2063) pertain to Medicare.  Other commercial payers are currently showing indication that they may be adding them to their fee schedules.  For now, most commercial payers have their own set of e-visit codes. The non-physician e-visit CPT codes are 98970-98972 for commercial payers.
  2. E-visits are not considered telehealth.  E-visits do not require place of service 02, but rather the place where the clinician is located (11 or 12).
  3. Medicare E-visits require an entirely new modifier to be placed on the claim, CR.  This modifier indicates catastrophic relief.
  4. In regards to documentation for e-visits, it is vital the therapist indicates that the patient-initiated and consented to the e-visit. 
  5. In regards to the seven-day time period to which an e-visit covers, the seven days start when the therapist responds to the initial communication from the patient.
  6. From our research to date, the majority of commercial payers are making rapid changes to allow for telehealth services.  However, the codes that they are allowing vary greatly across the nation. It is vital that you research and reach out to each commercial payer if you plan on billing telehealth for a commercial patient.  The most common advice we are receiving is that telehealth claims should be billed with a GT modifier and 02 for the place of service if a therapy provider has been approved for telehealth. 
  7. As of March 19, 2020, United Health Care did not have physical/occupational therapists listed on their approved list of telehealth providers.  However, you do have the option to bill e-visits similar to Medicare. The commercial CPT codes for e-visits are 98970-98972.  
  8. We have updated our Medicare Calculator to include the e-visits so that you can see what they reimburse for your locality.  Please click here to view and calculate your reimbursements.

Please be sure to bookmark this blog, as we will continue to provide updates as they become available. Stay safe. 

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