{"id":1096,"date":"2015-04-13T20:36:02","date_gmt":"2015-04-13T20:36:02","guid":{"rendered":"https:\/\/uat.itelcompanies.com\/?p=1096"},"modified":"2015-04-13T20:36:02","modified_gmt":"2015-04-13T20:36:02","slug":"telehealth-reimbursement-codes","status":"publish","type":"post","link":"https:\/\/uat.itelcompanies.com\/?p=1096","title":{"rendered":"Telehealth Reimbursement Codes"},"content":{"rendered":"

Reimbursement for telehealth is not simple to understand. You can spend a couple hundred dollars on webinars trying to figure out\u00a0how<\/em> reimbursement works, and still not understand if\/how to get reimbursed, or if private payers, or Medicare\/Medicaid will cover the telehealth session. Plus, since reimbursement differs from State to State, and from plan to plan, there is no clear answer.<\/p>\n

An overview of how telehealth reimbursement works is as follows:<\/p>\n

Medicare\/Medicaid, depending on State, may reimburse for the telehealth session + a telehealth originating site fee (CPT code Q3014).<\/p>\n

Private Insurance covers telehealth in 18 States (see the National Conference of State Legislature\u00a0<\/a>\u00a0(NCSL) webpage to find out more about your State). The map below from NCSL shows which States do and do not cover for reimbursement.<\/p>\n

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\u00a0List of codes that can qualify for telehealth reimbursement<\/h2>\n<\/td>\n<\/tr>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 90791 and 90792: Psychiatric diagnostic interview examination<\/td>\n<\/tr>\n
\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 90832 \u2013 90834 and 90836 \u2013 90838: Individual psychotherapy<\/td>\n<\/tr>\n
\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 90951, 90952, 90954, 90955, 90957, 90958, 90960, and 90961: End-Stage Renal Disease related<\/td>\n<\/tr>\n
\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 services included in the monthly capitation payment<\/td>\n<\/tr>\n
\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 96116: Neurobehavioral status examination<\/td>\n<\/tr>\n
\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 96150 \u2013 96154: Individual and group health and behavior assessment and intervention<\/td>\n<\/tr>\n
\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 97802 \u2013 97804 and G0270: Individual and group medical nutrition therapy<\/td>\n<\/tr>\n
\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 99201 \u2013 99215: Office or other outpatient visits<\/td>\n<\/tr>\n
\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 99231 \u2013 99233: Subsequent hospital care services, with the limitation of 1 telehealth visit every 3 days<\/td>\n<\/tr>\n
\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 99307 \u2013 99310: Subsequent nursing facility care services, with the limitation of 1 telehealth visit every 30 days<\/td>\n<\/tr>\n
\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 99406 and 99407 and G0436 and G0437: Smoking cessation services<\/td>\n<\/tr>\n
\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 G0108 and G0109: Individual and group diabetes self-management training services, with a minimum of 1 hour of in-person instruction to be furnished in the initial year training period to ensure effective injection training<\/td>\n<\/tr>\n
\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 G0396 and G0397: Alcohol and\/or substance (other than tobacco) abuse structured assessment and intervention services<\/td>\n<\/tr>\n
\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 G0406 \u2013 G0408: Follow-up inpatient telehealth consultations furnished to beneficiaries in hospitals or SNFs<\/td>\n<\/tr>\n
\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 G0420 and G0421: Individual and group kidney disease education services<\/td>\n<\/tr>\n
\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 G0425 \u2013 G0427: Telehealth consultations, emergency department or initial inpatient<\/td>\n<\/tr>\n
\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 G0442: Annual alcohol misuse screening, 15 minutes<\/td>\n<\/tr>\n
\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 G0443: Brief face-to-face behavioral counseling for alcohol misuse, 15 minutes<\/td>\n<\/tr>\n
\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 G0444: Annual depression screening, 15 minutes<\/td>\n<\/tr>\n
\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 G0445: High-intensity behavioral counseling to prevent sexually transmitted infection; face-to-face, individual, includes: education, skills training and guidance on how to change sexual behavior; performed semi-annually, 30 minutes<\/td>\n<\/tr>\n
\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 G0446: Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes<\/td>\n<\/tr>\n
\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 G0447: Face-to-face behavioral counseling for obesity, 15 minutes<\/td>\n<\/tr>\n
\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 G0459: Inpatient pharmacologic management<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n","protected":false},"excerpt":{"rendered":"

Reimbursement for telehealth is not simple to understand. You can spend a couple hundred dollars on webinars trying to figure out\u00a0how reimbursement works, and still not understand if\/how to get reimbursed, or if private payers, or Medicare\/Medicaid will cover the telehealth session. Plus, since reimbursement differs from State to State, and from plan to plan, […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-1096","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/uat.itelcompanies.com\/index.php?rest_route=\/wp\/v2\/posts\/1096"}],"collection":[{"href":"https:\/\/uat.itelcompanies.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/uat.itelcompanies.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/uat.itelcompanies.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/uat.itelcompanies.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=1096"}],"version-history":[{"count":6,"href":"https:\/\/uat.itelcompanies.com\/index.php?rest_route=\/wp\/v2\/posts\/1096\/revisions"}],"predecessor-version":[{"id":1103,"href":"https:\/\/uat.itelcompanies.com\/index.php?rest_route=\/wp\/v2\/posts\/1096\/revisions\/1103"}],"wp:attachment":[{"href":"https:\/\/uat.itelcompanies.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1096"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/uat.itelcompanies.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1096"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/uat.itelcompanies.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1096"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}