Question: Can we bill for telemedicine services in sleep medicine (consults, follow-up encounters)? What is the code for that?
Answer: Coverage of telemedicine services is payer specific. Providers should contact private payers directly for information regarding coverage of telemedicine services.
Medicare covers services provided using telemedicine for patients in rural Health Professional Shortage Areas (HPSAs). Centers billing for services provided via telemedicine may use codes included in Medicare’s approved telemedicine code list. The place of service (POS) code 02 is then added to the code to indicate that the service was provided by telemedicine. For example, a level two established Medicare patient office visit at a rural health clinic with an RN provided via telemedicine would be billed as “99213, 02.” Medicare providers in nearly all states can only bill synchronous (“real-time”) telemedicine services. However, telemedicine demonstrations in Alaska and Hawaii can report services with the GQ modifier to indicate that a service was rendered asynchronously.
CMS recently finalized the addition of several new Healthcare Common Procedure Coding System (HCPCS) and Current Procedural Terminology (CPT) telemedicine codes in the 2019 Physician Fee Schedule, including:
- Brief Communication Technology-based Service (HCPCS code G2012)
- Remote Evaluation of Pre-Recorded Patient Information (HCPCS code G2010)
- Interprofessional Internet Consultation (CPT codes 99451, 99452, 99446, 99447, 99448, 99449)
- Chronic Care Remote Physiologic Monitoring (CPT codes 99453, 99454, and 99457)
The AASM Coding and Compliance Committee will review these codes and provide recommendations to the membership on reporting for 2019 and beyond.