Purview Healthcare

What is Telehealth Billing?

credentialization

Medical Billing for Telehealth: A Guide for Different Specialties (by Purview Healthcare)

In today’s healthcare landscape, telehealth has become an increasingly popular option for both patients and providers.  Purview Healthcare, a leading medical billing services company in the USA, understands the complexities of navigating the evolving world of telehealth billing. 

This guide provides an overview for different specialties to ensure you receive proper reimbursement for your telehealth services.

What is Telehealth Billing?

Telehealth billing refers to the process of submitting claims for virtual healthcare encounters. Unlike traditional in-person billing, telehealth billing requires specific codes and considerations to ensure accurate reimbursement.

Key Considerations for Telehealth Billing

  1. Place of Service (POS) Codes: When billing for telehealth services, it’s crucial to utilize the correct POS code. This typically involves adding modifier -95 to the standard E/M (Evaluation and Management) code to indicate the service was delivered via telehealth.
  2. Patient Location: Patient location can impact billing depending on state regulations. Some states require patients to be located in specific healthcare facilities during telehealth visits, while others allow more flexibility.
  3. Telehealth Parity Laws: Thankfully, many states and the federal government have enacted telehealth parity laws. These laws ensure telehealth services are reimbursed at similar rates to in-person visits, promoting greater access to care.

Benefits of Telehealth for Patients and Providers

  1. Convenience: Patients can access healthcare from the comfort of their homes.
  2. Accessibility: Telehealth bridges the gap for patients in remote or underserved areas.
  3. Efficiency: Reduces travel time and waiting periods for both patients and providers.

 

Common Telehealth Services Offered by Different Specialties

  • Primary care consultations
  • Mental health therapy sessions
  • Pediatric consultations
  • Chronic disease management and monitoring

 

Differences Between Traditional and Telehealth Billing

  • Service Delivery: Traditional billing involves in-person visits, while telehealth billing covers virtual consultations.
  • Code Usage: Different sets of codes are used to distinguish between in-person and telehealth services.

 

Common Challenges in Telehealth Billing

  • Understanding and applying the correct telehealth billing codes.
  • Keeping up with changing regulations and insurance policies.
  • Ensuring accurate and complete documentation for reimbursement.

 

Telehealth Billing Codes by Specialty (CPT Codes)

Common Telehealth CPT Codes

CPT (Current Procedural Terminology) codes are used to categorize specific healthcare services for billing purposes.  There are specific CPT codes designated for telehealth visits.  For a comprehensive list of telehealth CPT codes, you can visit the American Medical Association website ([search cpt codes for telehealth ON American Medical Association ama-assn.org]).

Telehealth Billing Codes for Specific Specialties

Here’s a breakdown of some common telehealth billing codes for various specialties:

Primary Care:

  • 99441-99443: Telehealth consultations for new or established patients.
  • 99421-99423: Chronic disease management via telehealth.
  • 99377-99379: Preventive care visits conducted virtually.

Mental Health:

  • 90832-90828: Individual psychotherapy sessions delivered via telehealth.
  • 90809: Medication management for established patients using telehealth.

Dermatology:

  • 99372-99373: Telehealth consultations for new or established patients with skin conditions.
  • 99411-99413: Follow-up telehealth visits for dermatological conditions.

Importance of Using Correct Telehealth Codes

Using accurate telehealth codes is crucial for:

  • Ensuring proper reimbursement.
  • Avoiding claim denials and delays.
  • Complying with regulatory requirements.

Examples of Frequently Used Telehealth Codes

  • 99441-99443: Telephone evaluation and management services.
  • G2010: Remote evaluation of recorded video and/or images.
  • G2012: Brief communication technology-based service.

Telehealth Services in Mental Health Care

  • Therapy sessions.
  • Psychiatric evaluations.
  • Medication management.

Important Telehealth Codes CPT for Mental Health

  • 90791-90792: Psychiatric diagnostic evaluation.
  • 90834: Psychotherapy, 45 minutes with patient.
  • 90837: Psychotherapy, 60 minutes with patient.

Best Practices for Billing Mental Health Telehealth Services

  • Maintain detailed session notes.
  • Use appropriate time-based CPT codes.
  • Verify coverage for telehealth mental health services.

 

Telehealth Billing for Pediatrics

Unique Aspects of Telehealth in Pediatrics

  • Developmental screenings.
  • Immunization follow-ups.
  • Parental guidance and support.

 

Key Telehealth Billing Codes for Pediatric Care

  • 99381-99395: Preventive medicine services.
  • 99441-99443: Telephone evaluation and management services.

Tips for Effective Pediatric Telehealth Billing

  • Accurately document the child’s medical history and telehealth visit details.
  • Use age-specific CPT codes.
  • Communicate clearly with parents about billing and insurance coverage.

Telehealth Billing for Chronic Disease Management

Importance of Telehealth for Chronic Disease Management

  • Continuous monitoring of chronic conditions.
  • Remote consultations and follow-ups.
  • Patient education and support.

Relevant Telehealth CPT Codes for Chronic Disease Care

  • 99495-99496: Transitional care management services.
  • 99490: Chronic care management services.

 

Common Telehealth Billing Errors and How to Avoid Them

Typical Mistakes in Telehealth Billing

  • Incorrect use of telehealth billing codes.
  • Incomplete documentation.
  • Failing to use appropriate modifiers.

Impact of Billing Errors on Healthcare Providers

  • Delayed or denied reimbursements.
  • Increased administrative costs.
  • Potential legal issues and penalties.

 

Tips for Avoiding Common Telehealth Billing Mistakes

  • Double-check codes and documentation before submission.
  • Train staff regularly on telehealth billing practices.
  • Utilize billing software to streamline the process.

The Role of Medical Coding Services in Telehealth Billing

Overview of Medical Coding Services in the USA

Medical coding services involve translating healthcare services, procedures, and diagnoses into standardized codes for billing and record-keeping purposes.

How Professional Medical Coding Services Enhance Telehealth Billing Accuracy

  • Expertise in coding ensures the use of correct telehealth CPT codes.
  • Reduces the risk of errors and claim denials.
  • Ensures compliance with current regulations and insurance policies.

 

Benefits of Outsourcing Medical Coding Services for Telehealth

  • Access to specialized knowledge and expertise.
  • Improved efficiency and accuracy in billing.
  • Allows healthcare providers to focus on patient care.

 

Benefits of Using Purview Healthcare for Telehealth Billing

Managing the complexities of telehealth billing can be time-consuming and challenging.  Purview Healthcare can streamline the process and ensure you receive maximum reimbursement for your services.

  • Streamlined Billing Process: Our team of experts has in-depth knowledge of telehealth billing regulations and utilizes advanced technology for accurate and efficient coding.
  • Increased Revenue Recovery: With Purview Healthcare’s expertise, you can maximize reimbursements for your telehealth services and minimize claim denials.
  • Peace of Mind: Focus on delivering exceptional patient care while our team handles the intricacies of telehealth billing. This frees up valuable time for your staff to focus on other priorities.

 

Conclusion

Understanding telehealth billing is crucial for different specialties to ensure proper reimbursement and continued access to virtual care.  Purview Healthcare can be your trusted partner in navigating the ever-changing world of telehealth billing.  

Contact us today for a consultation on your specific telehealth billing needs.

Share On

Facebook
Twitter
LinkedIn

Didn’t find what you were looking for? Please share your contact details and our team will reach out to you within 24 hrs. Thank You

Enquiry for RCM (Pop-up)
Enquiry for VBS (Pop-up)
Enquiry for RWH (Pop-up)
Enquiry for RCM (Pop-up)

Contact Us for Free Practice Analysis

Enquiry for Free Practice Analysis