Your telehealth reimbursement questions, answered

Your telehealth reimbursement questions, answered


Healthcare consultant Elizabeth Woodcock answers common questions about telehealth use, reimbursement and coding in the new post-COVID-19 world.

The telehealth questions answered in this interview were gathered from physician questions from the COVID-19 Physician Survival Guide webinar hosted by Medical Economics in April. Woodcock was one of the presenters, and physicians asked more than 150 questions. In an effort to answer these questions, Medical Economics and Woodcock conducted this interview.


The telehealth questions answered in this video interview include:


  • Where can physicians go to get the most correct and up-to-date information when it comes to telehealth coding, documentation rules?
  • We received a ton of questions about reimbursement for old fashioned phone calls without using video. Can you explain the current reimbursement rules regarding phone calls?
  • What do physicians need to know and do to get paid for using Modifier CS?
  • Do the relaxed rules regarding telehealth, etc., only apply to Medicare? What is the best way to learn how private payers are approaching telehealth reimbursement?
  • We received a ton of questions regarding place of service. What are the current rules regarding POS in order to receive the best possible reimbursement rates?
  • Can the G2012 code be used for follow-up phone calls following a telemedicine visit?  For ex,. a new medication is started, and you want to check on patient 3 days later regarding efficacy and side effects.
  • We received many questions about using modifier -95 in regard to telehealth visits. Can you first off explain what modifier -95 is, and then how it should be properly used for telehealth documentation?
  • Can you use modifier 95 and CS at the same time?
  • Can you bill with modifier CS if a patient is evaluated for signs and symptoms of COVID-19 but no testing is ordered?
  • Are any payers still requiring providers to use a secure telehealth platform despite the relaxed rules?
  • What do physicians need to know in regards to relaxed rules on HIPAA, etc. It’s almost like the wild west right now, but what advice do you have to make sure physicians are still keeping patient privacy at the forefront?
  • If a telehealth call is interrupted due to technical issues, can it still be billed?
  • Are there any other important points for physicians to know about in regard to telehealth billing/coding that we did not discuss?




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