Billing for Telemedicine Services

<< All News Wednesday, April 1, 2020 Categories: Medical Provider All News Medical Provider Billing

WSI previously published an article about expanding eligible telemedicine services due to COVID-19.  After receiving several follow-up questions from providers, WSI is providing clarification on the types of telemedicine services and billing codes allowed for the duration of the emergency declaration.

General Information

  • WSI developed these guidelines based on a recent waiver authority issued by Centers for Medicare & Medicaid Services (CMS).
  • Originating site may include the injured employee’s home.
  • Bill must include appropriate HCPCS or CPT code and Place of Service 02.
  • Medical documentation must accompany the bill and support the telemedicine service charged.

Telehealth Visit

  • Description: Visit with a provider using an interactive audio-video or audio only telecommunication system.
  • Telehealth services must have modifier -95 appended to applicable service line item(s).
  • Common telehealth visit codes include:
    •  99201-99215 (Office or other outpatient services)
    •  G0425-G0427 (Telehealth consultations, emergency department or initial inpatient)
    • G0406-G0408 (Follow-up inpatient telehealth consultations
  • A provider may review CMS’ Covered Telehealth Services for Public Health Emergency for the COVID-19 Pandemic for a complete list. WSI will honor a code from this list if the code is reimbursable in accordance with WSI Fee Schedule.

Virtual Check-In

  • Description: Brief communication with a provider via telephone or other telecommunication device to decide whether an injured employee needs to have an office visit or other service; remote evaluation of recorded video and/or images submitted by an injured employee.
  • Billable Codes:
    • 99441-99443 (Non-face-to-face telephone services)
    • G2012 (Brief communication technology-based service)
    • G2010 (Remote evaluation of recorded video or images)

E-Visit

  • Description: Communication initiated by an injured employee to a provider through a portal.
  • Billable Codes:
    • 99421-99423 (Online digital E&M service)
    • 98970-98972 (Qualified nonphysician online digital E&M service)
    • G2061-G2063 (Qualified nonphysician online assessment)

If you have questions about this article, please send an email to wsipr@nd.gov. Click here to sign-up to receive email notifications of the latest Medical Provider News. Make sure to follow us on Facebook and Twitter.

For the most up-to-date and timely information related to COVID-19, visit the North Dakota Department of Health website at www.health.nd.gov/coronavirus, follow them on Facebook, Twitter and Instagram, and visit the CDC website at www.cdc.gov/coronavirus.

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