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Originally Posted by Leah123
I see Skies response has many links but mostly focused on Medicare
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That's because Medicare drives the policies for other healthcare organizations.
The organizations you see providers through Leah are different in terms of payment issues of hospitals and other healthcare organizations.
The CPT codes determine provider reimbursement. So generally if the insurance company pays the procedure codes below, then the services would be reimbursed pending meeting other guidelines if provided by qualified providers in private practice, hospitals, outpatient organizations, etc., who take that insurance.
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Services conducted via telehealth and reimbursed by Medicaid and Medicare use the same billing codes as face-to-face (with a "GT" modifier). These services include:- Consultations (CPT codes 99241-99275)
- Office or other outpatient visits (CPT codes 99201 - 99215)
- Individual psychotherapy (CPT codes 90832 (30 minutes) 90834 (45 minutes) 90837 (60 minutes)
- Pharmacologic management (CPT code 99213 for outpatient, 99212 for refills, 99214 for complex situations.
- Psychiatric diagnostic interview examination (CPT code 90791 and 90792
- Neurobehavioral status exam (HCPCS code 96116)
- Initial Assessment (96150)
- Intervention - Individual (96152)
- Problem Focused (G0425)
- G0426 (Detailed): HCPCS G0427 (Comprehensive):
- G0406: Follow-up inpatient telehealth consultation, limited, 15 minutes communicating with the patient via telehealth;
- G0407: Follow-up inpatient telehealth consultation, intermediate, 25 minutes communicating with the patient via telehealth;
- G0408: Follow-up inpatient telehealth consultation, complex, 35 minutes or more communicating with the patient via
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