Posted by Kym Tolson, LCSW
Is your practice fully remote? If it is, you are living the dream. You provide valuable mental healthcare from home, your hotel room, from anywhere. Your clients aren’t locked into an office setting. They can receive your care from any safe and nurturing place of their choosing as well. It’s a good thing. You’re doing the work.
So, now all you have to do is bill for your services.
Not so easy? If you’re honest, the idea of sifting through the rules and parameters is likely intimidating.
Do you find yourself, hedging, procrastinating, or even outsourcing your claims to people who might not have your best interests at heart? You aren’t alone. If you find yourself held back by the thought of tackling billing on your own or tired of feeling inadequate or uninformed, you’ve come to the right source.
Firstly, before you do anything, you need to know who you’re working with.
While it’s true that COVID-19 has ushered in a wider range of telehealth services, communicating clearly with your patients and providers is vital to avoiding billing missteps. Foremost, it is wise to request that your patients confirm their own insurance coverage before each appointment. Then, follow up by corroborating coverage and verifying each insurance provider policy. Keep a list of telehealth eligible CPT codes from each payer.
As discussed in a previous post, POS(place of service) codes are two-digit codes reported on Form CMS-1500. These codes clarify the services performed and ensure that each claim is properly settled. As you may already know, there are two applicable POS codes at work:
1. Billing Code POS 02. This code indicates that telehealth service was administered without identifying where your patient received it.
This applies to situations where therapy services were 1) provided via telecommunication technology like Zoom and 2) where your patient is not located in their home while working with you.
2. Billing Code POS 10. This billing code is a result of COVID-19 public safety expansion. It allows for a patient’s place of residence to be the site of all mental healthcare.
Diagnosis, evaluation, and therapy can all be accomplished and billed under this code. Please note that employing POS 10 will become possible in April 2022 for most commercial insurances. At that point, CMS is still wanting us to bill 11 as the location and 95 for the telehealth modifier.
As you learn more about billing, you will also learn more about the differences in federal offerings, state providers, and private insurers. This is important to recognize in how teletherapy accommodations are administered.
For example, as it pertains to audio vs. video teletherapy, Medicare may be billed for both audio and video telehealth. However, audio-only therapy is currently covered only for the duration of the pandemic public health emergency by other insurers. Moreover, some providers only cover video teletherapy.
Thus, as you travel and practice, it’s important to determine which codes apply and for how long. You may want to hire a qualified virtual assistant to help too if you feel it would help you stay current.
Hopefully, you have found this info helpful and you aren’t too worried about billing to postpone your travels! Don’t worry if you have more telehealth billing questions. You aren’t alone and you have resources that travel with you! In fact, you have qualified, up-to-date telehealth billing support offered without judgment anytime.
Currently, I run a Facebook group for insurance billing for Telehealth to help you in real-time. You can talk things through with others who are looking to master telehealth on the go as well. When you are ready, link here, and join us soon to start making teletherapy billing a breeze.