Impact of Telehealth on Medical Billing, Reimbursement & its Guidelines

Telehealth has become increasingly popular over the last few years, especially during the COVID-19 pandemic. Telehealth refers to the use of technology to deliver healthcare services remotely, including consultations, diagnoses, and treatments. While telehealth has made healthcare more accessible to many people, it has also had a significant impact on medical billing and reimbursement. In this blog, we will explore the impact of telehealth on medical billing and reimbursement.

Telehealth reimbursement policies

One of the most significant impacts of telehealth on medical billing and reimbursement is the evolving policies surrounding telehealth services. Due to the sudden increase in demand for telehealth services, many insurance companies and healthcare providers had to navigate new policies and regulations around telehealth reimbursement.

Increased efficiency

Telehealth has also led to an increase in efficiency in medical billing and reimbursement. With the use of telehealth, providers can submit claims and receive reimbursements more quickly. This can lead to a reduction in administrative work and can help providers get paid faster.

Changes in coding

With the rise of telehealth, there have been changes in coding to accommodate telehealth services. For example, the Centers for Medicare and Medicaid Services (CMS) has introduced new codes for telehealth services, including codes for remote monitoring and virtual check-ins. These changes in coding have made it easier for providers to bill for telehealth services accurately.

Billing for telehealth services

To bill for telehealth services, providers must follow specific guidelines. For example, providers must ensure that the telehealth services provided are medically necessary and follow the same guidelines as in-person visits. Providers must also document the services provided and ensure that the telehealth visit is billed accurately.

Potential for increased revenue

Telehealth has the potential to increase revenue for healthcare providers. With the ability to offer telehealth services, providers can reach more patients and offer services that they may not have been able to provide before. This can lead to an increase in revenue for providers and can help to offset the costs of implementing telehealth services.

Telehealth Billing Guidelines

Telehealth billing guidelines can vary depending on the specific payer and state regulations, but here are some general telehealth billing guidelines for 2022 that providers should be aware of:

  1. Eligibility requirements: Providers must ensure that their telehealth services meet the eligibility requirements for reimbursement. For example, some payers may only cover telehealth services for certain diagnoses or in specific locations.
  2. Place of service code: When billing for telehealth services, providers must use the appropriate place of service (POS) code to indicate that the service was provided via telehealth. In 2022, the POS code for telehealth services is “02.”
  3. Modifier codes: Providers may also need to use modifier codes to indicate that a service was provided via telehealth. For example, the GT modifier may be used for Medicare claims, while the 95 modifier is used for commercial claims.
  4. Reimbursement rates: Providers should check with their payers to determine the reimbursement rates for telehealth services. Some payers may have different reimbursement rates for telehealth services than for in-person services.
  5. Documentation: Providers must document the telehealth services provided, including the patient’s consent, the services provided, and any follow-up care that is recommended. Documentation should follow the same guidelines as for in-person visits.
  6. Telehealth platform: Providers should use a HIPAA-compliant telehealth platform to ensure the security and privacy of patient information.
  7. State regulations: Providers should be aware of any state regulations related to telehealth services, including licensing requirements and regulations around reimbursement.

It’s important for providers to stay up-to-date on telehealth billing guidelines as they continue to evolve. Providers can consult with medical billing and reimbursement companies or professional organizations for the latest guidelines and updates. By following these guidelines, providers can ensure accurate billing and reimbursement for their telehealth services in 2022.

In conclusion, telehealth has revolutionized the healthcare industry, making healthcare services more accessible and efficient for patients and providers alike. While the impact on medical billing and reimbursement has been significant, it has also opened up new opportunities for providers to reach more patients and increase revenue. By staying up-to-date on the latest policies and coding changes, providers can ensure accurate billing and reimbursement for telehealth services. Additionally, utilizing the services of a reputable medical billing and reimbursement company can provide peace of mind and allow providers to focus on delivering quality care to their patients. Overall, the benefits of telehealth and medical billing reimbursement services are clear, and as technology continues to evolve, it will be exciting to see how it will continue to transform the healthcare industry for the better. For medical billing and telehealth services, please schedule 1:1 with one of our dedicated billing manager today!

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