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January 25, 2018


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Medical Coding News Archives

List of Approved Telehealth Services Is Updated

 
May 12, 2009:

The Centers for Medicare and Medicaid Services has recently updated the list of procedures approved as telehealth services. This update was necessary since in 2009 several new CPT procedure codes related to end-stage renal disease (ESRD) services were added, replacing previous HCPCS level II G codes, which were then deleted. Telehealth services must be reported with modifiers GT or GQ appended to the code to identify the type of technology used.

GQ Via asynchronous telecommunications system
GT Via interactive audio and video telecommunications

Effective January 1, 2009, carriers and Medicare administrative contractors (MAC) will pay for CPT codes 90951, 90952, 90954, 90955, 90957, 90958, 90960, and 90961 according to the appropriate physician or practitioner fee schedule amount when submitted with modifier GT or GQ.

Also effective January 1, 2009, fiscal intermediaries or MACs will pay for CPT codes 90951, 90952, 90954, 90955, 90957, 90958, 90960, and 90961 according to the appropriate physician or practitioner fee schedule amount when submitted with modifier GT or GQ by critical access hospitals that have elected method II on type of bill 85X.

Note: Contractors do not have to search their files and reprocess claims for CPT codes 90951, 90952, 90954, 90955, 90957, 90958, 90960, and 90961 with dates of service on or after January 1, 2009, but will adjust any claims for these services brought to their attention.

Medicare requires the use of interactive audio and video telecommunications that allow for real-time communication between the beneficiary and the physician or other practitioner at the distant site. This may include x-rays, EKGs, MRIs, laboratory results, audio clips, photographs specific to the patient’s condition that are capable of rendering or supporting a diagnosis, and text. It does not include telephone calls, electronic mail, or images transmitted via facsimile. CMS developed modifier GQ, via asynchronous telecommunications system, to identify the use of store-and-forward technology.

Deborah C. Hall
Clinical/Technical Editor

 

 
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