Adoption of CPT® Guidelines for Telemedicine Services

WSI has adopted the AMA’s CPT® Guidelines for telemedicine services. Telemedicine seeks to improve a patient's health by permitting two-way, real time interactive communication between the patient and a physician or practitioner at a distant site. The CPT Guidelines indicate telemedicine services involve the use of interactive telecommunications equipment that, at a minimum, includes both audio and video. CPT codes approved for telemedicine are identifiable by the presence of a ★ symbol preceding the code. The AMA also collectively lists these services in Appendix P of the CPT Guidelines.

A provider should submit a claim for a telemedicine service using Place of Service (POS) code 02. Appropriate billing includes the CPT or HCPCS code for the professional service appended with modifier GT or 95. WSI issues reimbursement for the CPT code billed per WSI fee schedule, when deemed medically necessary and related to the work injury.

WSI also allows reimbursement for an originating site fee per WSI Fee Schedule. A provider should submit a claim for this service with HCPCS code Q3014 on a CMS-1500 using POS 02 or a UB-04 using type of bill 131.

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