Aetna Telehealth Modifier Code

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COVID19: Billing & Coding FAQs for Aetna Providers

Billing Aetna.com Get All

1 hours agoFee schedules have been updated so claims with approved telemedicine CPT codes and modifiers with POS 02 will be reimbursed at the same rate as an equal office visit. For example, a telemedicine service 99213 GT with POS 02 will reimburse the same as a face-to-face in-office visit 99213. Urgent Care Centers should continue to use POS 20.

Link: https://www.aetna.com/health-care-professionals/covid-faq/billing-and-coding.html

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COVID19 Telemedicine Coverage FAQs for Aetna Providers

Coverage Aetna.com Get All

5 hours agoFee schedules have been updated so claims with approved telemedicine CPT codes and modifiers with POS 02 will be reimbursed at the same rate as an equal office visit. For example, a telemedicine service 99213 GT with POS 02 will reimburse the same as a face-to-face in-office visit 99213.

Link: https://www.aetna.com/health-care-professionals/covid-faq/telemedicine.html

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Updated Telehealth Codes Aetna Better Health

Updated Aetnabetterhealth.com Get All

7 hours agoAetna Better Health of New Jersey Guidance on Telehealth Services Aetna Better Health of New Jersey allows reimbursement for telemedicine/telehealth performed within

Link: https://www.aetnabetterhealth.com/newjersey/assets/pdf/providers/Updated Telehealth Codes.pdf

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Approved Behavioral Health Telemedicine Services Aetna

Approved Aetna.com Get All

9 hours ago• NY – Audio coverage for IOP codes H0015, H2012 and S9480 Aetna is the brand name used for products and services provided by one or more of the Aetna group of companies, including Aetna Life Insurance Company and its affiliates (Aetna). The above list of codes eligible for reimbursement via various telemedicine

Link: https://www.aetna.com/content/dam/aetna/pdfs/aetnacom/health-care-professionals/bh-televideo-service-codes-covid-19.pdf

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Aetna Telehealth Billing for Therapy and Mental Health

Aetna Therathink.com Get All

8 hours agoYou can review their approve CPT codes here: Aetna Telehealth CPT Codes for Behavioral Health Treatment 2020. Like with all major insurance companies, Aetna requires mental health providers to utilize their normal range of CPT codes. Common CPT codes for Telehealth can be found at our telehealth billing guide.

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Link: https://therathink.com/aetna-telehealth-billing/

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Aetna Telehealth Cpt Codes LifeHealthy.Net

Aetna Life-healthy.net Get All

2 hours agoCOVID19: Billing & Coding FAQs for Aetna Providers. Billing Aetna.com Get All . 1 hours ago Fee schedules have been updated so claims with approved telemedicine CPT codes and modifiers with POS 02 will be reimbursed at the same rate as an equal office visit. For example, a telemedicine service 99213 GT with POS 02 will reimburse the same as a face-to-face in-office visit 99213.

Link: https://life-healthy.net/aetna-telehealth-cpt-codes/

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Telemedicine Billing Guidelines FQHC & RHC COVID19 Aetna

Billing Aetnabetterhealth.com Get All

2 hours agoProfessional Claims CMS 1500: Bill with GT Modifier & POS-02 (in addition other applicable modifiers) Additional Telemedicine billing guidance for FQHCs and RHCs • FQHC’s and RHC’s can bill for Telemedicine services and should submit their claims with HCPCS code T1015 plus any additional appropriate CPT/HCPCS codes

Link: https://www.aetnabetterhealth.com/pennsylvania/assets/pdf/provider/Telemedicine Billing Guidelines FQHC RHC COVID-19_2.pdf

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Telehealth/Telemedicine COVID19 Billing Cheat Sheet

Billing Files.nc.gov Get All

6 hours ago-95 is a CPT code modifier -GT and -GQ are HCPCS codes modifiers -CR is appended as a second modifier if required by payer. Patient Consent for telehealth: Providers must obtain and document patient consent to telehealth services. Some payers allow this to be done verbally. Refer to specific payer policies.

Link: https://files.nc.gov/hiea/documents/files/Telehealth-Coding-Cheatsheet_0.pdf

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Updated policy for telemedicine Aetna

Updated Aetna.com Get All

2 hours agoThis updated policy will take effect as of January 1, 2020. At that time, you will be able to review the payment policy and approved codes on the provider website. Billing. When billing for eligible services rendered via telemedicine, as explained above, you must bill them using the appropriate telemedicine modifier representing two-way, real

Link: https://www.aetna.com/health-care-professionals/newsletters-news/office-link-updates-december-2019/news-for-you-december-2019/updated-policy-for-telemedicine.html

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TELEHEALTH/EVISIT QUICK REFERENCE GUIDE – April 14, 2020

QUICK Ppta.org Get All

204-14-20209 hours ago3. Aetna will pay for telehealth by institutional providers on a UB04 using GT or 95 modifier AETNA E-VISITS March 26 - June 4th, 2020. CORRECTED 4-14-20 No modifier 98970 98971 . 98972 . G codes for E-Visits: G2061 . G2062 . G2063. Still allowed by PT in policy in addition to telehealth * NOTE: 1.

Link: https://www.ppta.org/assets/COVID/PPTA Payer Update Table for Telehealth E-visits 4-14-2020.pdf

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Aetna Telehealth Procedure Codes 2021 Guidelines Life

Aetna Life-healthy.net Get All

4 hours agoCOVID19: Billing & Coding FAQs for Aetna Providers. Billing Aetna.com Get All . 1 hours ago Fee schedules have been updated so claims with approved telemedicine CPT codes and modifiers with POS 02 will be reimbursed at the same rate as an equal office visit. For example, a telemedicine service 99213 GT with POS 02 will reimburse the same as a face-to-face in-office visit 99213.

Link: https://life-healthy.net/aetna-telehealth-procedure-codes-2021-guidelines/

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COVID19: Taking Action Aetna Telemedicine Policy Update

Taking Askmuellerconsulting.com Get All

3 hours agoModifiers GT, 95 COVID 19 Telemedicine Policy Enhancement Highlights •Aetna Commercial patients pay $0 for covered telemedicine visits until June 4, 2020 •Until further notice, Aetna is also expanding coverage of telemedicine visits to its Aetna Medicare members, so they can receive the care they need from you without leaving their homes

Link: https://www.askmuellerconsulting.com/wp-content/uploads/2020/03/Aetna-New-Telemedicine-Policy-Update-COVID-19-3-19-2020.pdf

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Telehealth Program Manual Updated: April 2020 Scope

Program Aetnabetterhealth.com Get All

Just Nowdoes not participate in the telehealth session with the participant, but enables the telehealth session by initiating the connection. Following the telehealth session, the psychiatrist may bill the appropriate E&M code and must use the “-GT” modifier in order to identify the claim as a telehealth delivered service.

Link: https://www.aetnabetterhealth.com/content/dam/aetna/medicaid/maryland/providers/pdfs/April2020 Telehealth Program Manual.pdf

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Billing and Claims Provider Training Aetna

Billing Aetnabetterhealth.com Get All

5 hours agoCOVID-19 Telemedicine Guidance. To better serve our members and providers and prevent communityspread of COVID -19, Aetna Better Health of Florida (ABHFL) has adopted AHCA’s telemedicine waivers/flexibilities and CPT/HCSPCS code sets for the duration

Link: https://www.aetnabetterhealth.com/florida/assets/pdf/provider/May 2020 - Monthly Provider Billing Claims Training - COVID-19, HH, and EIS.pdf

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Telemedicine Frequently Asked Questions (FAQs) For Aetna

Asked Dhr.delaware.gov Get All

8 hours agoTelemedicine Frequently Asked Questions (FAQs) For Aetna Members A message appears asking if you received a username or promo code, select, “No.” 5. You will be asked, “Do you have Teladoc through your Employer, Insurance Provider, or Organization?” 6. Enter “Aetna” and select continue.

Link: https://dhr.delaware.gov/benefits/medical/documents/aetna/telemedicine-faq.pdf

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Telemedicine and Direct Patient Contact

and Pamedsoc.org Get All

5 hours agoA list of eligible CPT/HCPCS codes is available here. When a provider reports modifier GT or 95, it certifies the patient received services via an audiovisual telecommunications system. • GT: Telehealth service rendered via interactive audio and video telecommunications system • 95: Synchronous telemedicine service rendered via real-time

Link: https://www.pamedsoc.org/docs/librariesprovider2/pamed-documents/telemedicine-aetna.pdf?sfvrsn=3cdfb52f_2

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AETNA BETTER ® HEALTH OF VIRGINIA

AETNA Aetnabetterhealth.com Get All

1 hours ago19. This billing reference will provide additional information, including specific codes, relating to COVID -19 testing and telehealth services. Billing for COVI D-19 Testing . CPT code for laboratory testing for COVID-19: • CPT code 87635 effective March 12 , 2020 • CPT codes c …

Link: https://www.aetnabetterhealth.com/virginia/assets/pdf/providers/notices/COVID-19 Billing Reference Guide_Updated 3.2.21.pdf

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Aetna Telemedicine Billing Information Sequent Health

Aetna Sequentphysicians.com Get All

1 hours agoModifier G0 We pay for tele-stroke services when appended with modifier G0. Telehealth services for diagnosis, evaluation, or treatment, of symptoms of an acute stroke; Telehealth Transmission Fees. HCPCS codes Q3014 and T1014. Charges for telehealth services or …

Link: https://www.sequentphysicians.com/aetna-procedures/

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Telehealth Billing: COVID19 Update Neolytix

Update Neolytix.com Get All

6 hours agoCPT ® code 99241 will be reimbursed for all other synchronous real-time virtual visits when billed with Place of Service 11. If the visit is related to COVID-19, the above-mentioned ICD10 diagnosis codes (Z03.818 or Z20.828) are required to be billed and reimbursement will be without customer copay/cost-share.

Link: https://neolytix.com/telehealth-billing-covid-19-update/

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Telehealth Billing for Therapists: The Definitive Guide [2021]

Billing Therathink.com Get All

1 hours agoTelehealth billing for therapists is complex, requiring the correct medical claims coding cpt codes, modifiers, and place of service code. Our exhaustive guide to telehealth billing for therapists will teach you how to code your mental health insurance claims for telehealth billing as the process to ensure you get paid every time.

Link: https://therathink.com/bill-telehealth-for-therapy/

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Telemedicine Billing Guidelines in AthenaPractice

Billing H1tech.com Get All

3 hours agoPayer Notes CPT Modifier POS; Aetna-Commercial Plans: Aetna will offer zero-copay telemedicine visits for any reason until June 4, 2020. Aetna will waive cost sharing for all video visits through the Aetna covered Teladoc system and in-network providers who deliver synchronous virtual care (a real-time visual connection) for all commercial plans (please note- self-insured plan sponsors can opt

Link: https://h1tech.com/blog/telemedicine-billing-guidelines-in-athenapractice-formerly-centricity-practice-solutions/

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AMA Telehealth policy, coding & payment American Medical

AMA Ama-assn.org Get All

9 hours agoCommon CPT codes for telemedicine services are listed below. The AMA’s coding scenarios (PDF) provide real-world examples of how to code for telehealth services. For commercial payers, we have compiled the resources on this page to help track expanding coverage for telemedicine services.

Link: https://www.ama-assn.org/practice-management/digital/ama-telehealth-policy-coding-payment

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CMS Adds 60+ New Telehealth Codes for 2021 Healthcare

CMS Healthcare.trainingleader.com Get All

6 hours agoMany of these 60+ new telehealth codes were added under Category 1—services similar to those already on the telehealth list—so there are unlikely to be any big surprises. Examples include: Prolonged services (G2212) Home visits (99347, 99348) Care planning for cognitively impaired patients (99483)

Link: https://healthcare.trainingleader.com/2021/02/new-telehealth-codes-for-2021/

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Telemedicine Billing Tips

Billing Capturebilling.com Get All

3 hours agoIf you bill telemedicine to a commercial insurance company you will use a regular E&M CPT code and a 95 modifier. Confirm that with the payer. Place of service code. When billing telehealth services, healthcare providers must bill the E&M code with place of service code 02 along with a GT or 95 modifier.

Link: https://capturebilling.com/telemedicine-billing-tips/

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Approved Behavioral Health Telemedicine Services

Approved Therathink.com Get All

9 hours agoCode Service Description G0459 Inpatient telehealth pharmacologic management, including prescription, use, and review of medication with no more than minimal psychotherapy. Approved list of telemedicine behavioral health services as of 3/19/2020. Aetna is the brand name used for products and services provided by one or more of the Aetna group

Link: https://therathink.com/wp-content/uploads/2020/03/bh-televideo-service-codes-covid-19.pdf

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Telemedicine Coding and Coverage

Coding Nysca.memberclicks.net Get All

5 hours agoThere are only 3 reimbursable codes for Medicare recipients – 98940, 98941, and 98942. These services require face to face time with your patients and cannot be delivered via phone or other means of electronic communication. As such, telemedicine services, at present, is a non-covered service for Medicare patients.

Link: https://nysca.memberclicks.net/index.php?option=com_dailyplanetblog&view=entry&year=2020&month=04&day=01&id=1532:telemedicine-coding-and-coverage

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Telemedicine coding : CodingandBilling

coding Reddit.com Get All

8 hours agoPOS 02 - Telehealth, use certifies that the telehealth service meets Medicare’s requirements for reimbursement. Modifiers: 95 - the service was performed via telehealth (audio and video). CR - (not being required at this time) payment is conditioned directly or indirectly on the presence of a "formal waiver"GQ - part of a federal telemedicine demonstration project in Alaska and Hawaii using

Link: https://www.reddit.com/r/CodingandBilling/comments/fwp2v9/telemedicine_coding/

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Billing codes for telephone and telehealth video visits

Billing Pinnacol.com Get All

1 hours agoTelehealth E&M services (video and audio) Add the modifier -95 to the E&M code and use place of service (location code) 02. 99201 – 99215 Office or other outpatient visits 99241 – 99245 Consultations. Physicians: Telephone E&M services (audio only) Use the appropriate place of service code. No modifier is required.

Link: https://www.pinnacol.com/knowledge-center/billing-codes-for-telephone-and-telehealth-visits

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Telehealth Visits AAFP Home

Visits Aafp.org Get All

4 hours agoMedicare requires audio-video for office visit (CPT 99201-99215) telehealth services. Audio-only encounters can be provided using the telephone evaluation and management codes (CPT codes 99441-99443).

Link: https://www.aafp.org/family-physician/patient-care/current-hot-topics/recent-outbreaks/covid-19/covid-19-telehealth/coding-scenarios-during-covid-19/telehealth.html

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Billing and coding Medicare FeeforService claims

Billing Telehealth.hhs.gov Get All

4 hours agoTelehealth CPT codes 99441 (5-10 minutes), 99442 (11-20 minutes), and 99443 (20-30 minutes) Reimbursements match similar in-person services, increasing from about $14-$41 to about $60-$137, retroactive to March 1, 2020. In addition, Medicare is temporarily waiving the audio-video requirement for many telehealth services during the COVID-19

Link: https://telehealth.hhs.gov/providers/billing-and-reimbursement/billing-and-coding-medicare-fee-for-service-claims/

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Temporary OrthoNet/ Aetna Telemedicine Process

Temporary Orthonet-online.com Get All

05.11.20Just NowTelemedicine Services for the Aetna Outpatient PT & OT Program - 04/22/20, 05/27/20, 6/4/20, 8/4/20, 8. I 3. 20, I 2/17 /20, 05/11/21 For the OrthoNet/Aetna Therapy program please use the following Telehealth/Telemedicine CPT codes below: Two-way, Synchronous (i.e. real­ time) Audiovisual Interactive Medical Service Modifiers GT, …

Link: https://www.orthonet-online.com/forms/aetna/Telemedicine Procedure_Aetna_Announcement_05.11.20.pdf

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TELEHEALTH/EVISIT QUICK REFERENCE GUIDE April 17, 2020

QUICK Ppta.org Get All

204-17-20209 hours ago3. Aetna will pay for telehealth by institutional providers on a UB04 using GT or 95 modifier AETNA E-VISITS March 26 - June 4th, 2020. No modifier 98970 98971 98972 G codes for E-Visits: G2061 G2062 G2063 Still allowed by PT in policy in addition to telehealth * NOTE: 1. Aetna will pay for institutional providers performing E-Visits (UB04, 780)

Link: https://www.ppta.org/assets/COVID/PPTA Payer Update Table for Telehealth E-visits 4-17-2020.pdf

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Aetna’s Nebraska

Nebraska Doi.nebraska.gov Get All

2 hours ago(for example, 99444 or 99211-99215), plus any required modifier (for example, GT or 95). Aetna Response: Please see the attached Telemedicine and Direct Patient Contact policy which contains CPT codes we normally cover and additional codes we will allow and waive cost share until June 4, 2020.

Link: https://doi.nebraska.gov/sites/doi.nebraska.gov/files/doc/TELEHEALTH QUESTIONS AND RESPONSES.pdf

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Aetna Now Covers Telehealth Delivered by PTs APTA

Aetna Apta.org Get All

1 hours agoThe telehealth care must be provided as a two-way synchronous (real-time) audiovisual service. Providers are required to append the GT modifier to the codes. Aetna's expansion follows a similar move by UnitedHealthcare. Aetna will also continue its policy that reimburses PTs for the provision of e-visits, virtual check-ins, and telephone services.

Link: https://www.apta.org/news/2020/04/02/aetna-now-covers-telehealth-delivered-by-pts

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Telemedicine and Direct Patient Contact

and Ncmedsoc.org Get All

4 hours agoA list of eligible CPT/HCPCS codes is available here. When a provider reports modifier GT or 95, it certifies the patient received services via an audiovisual telecommunications system. • GT: Telehealth service rendered via interactive audio and video telecommunications system • 95: Synchronous telemedicine

Link: https://www.ncmedsoc.org/wp-content/uploads/2020/03/Aetna-telemedicine.pdf

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Contact: [email protected] Commercial Payer Telehealth

Payer Aota.org Get All

4 hours agoTelehealth care must be provided as a two-way synchronous (real-time) audiovisual service. For commercial plans, non-facility telemedicine claims must use POS 02 with the GT or 95 modifier. Fee schedules have been updated so claims with approved telemedicine CPT codes and modifiers with POS 02 will be reimbursed at the same rate as an

Link: https://www.aota.org/~/media/Corporate/Files/Advocacy/Telehealth-Insurance-Companies-COVID.pdf

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Telemedicine Billing and Reimbursement FindACode

Billing Findacode.com Get All

4 hours agoAs of January 1, 2018, Medicare claims will no longer use the GT modifier to signify an interactive telemedicine service. Instead, telemedicine services will be indicated using the Place of Service (POS) code 02. The GQ modifier, for asynchronous telemedicine (only reimbursable in Alaska and Hawaii), should continue to be used when appropriate.

Link: https://www.findacode.com/articles/telemedicine-billing-and-reimbursement-32892.html

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Telehealth Medical Billing and Coding Forum AAPC

Medical Aapc.com Get All

5 hours agoAs of 03/31/2020, CMS states for telehealth, "report the POS code that would have been reported had the service been furnished in person." with modifier -95 to designate it was telehealth. This way, you will get full reimbursement for nonfacility location, instead of reduced facility rate with POS 02. Medicare will also now reimburse 99441-99443.

Link: https://www.aapc.com/discuss/threads/telehealth.172144/

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Telemedicine Telehealth Denials Aetna Texas Medical

Denials Aapc.com Get All

8 hours agoThis question is specifically for Aetna in Texas but any feedback is appreciated. I am getting no where fast when trying to get reimbursement from Aetna for Televisits. I've coded it all kinds of ways: POS 2 no modifiers, POS 2 modifier GT, and POS 2 modifier 95. Every claim is being denied for various reasons: (1) Missing/incomplete/invalid

Link: https://www.aapc.com/discuss/threads/telemedicine-telehealth-denials-aetna-texas.165676/

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Basics of Telemedicine Reimbursement E2E Medical Billing

Basics E2emedicalbilling.com Get All

6 hours agoMost payers advise providers billing telemedicine to use the appropriate evaluative and management CPT code (99201 – 05, 99211-15) along with a GT modifier. Medicare covers a long list of eligible CPT codes and some private payers may prefer that you use the telemedicine specific code 99444. It varies based on the payer and the state you live in.

Link: https://www.e2emedicalbilling.com/blog/basics-of-telemedicine-reimbursement/

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Telehealth Reimbursement and Payment Models

and News.choosehealthde.com Get All

3 hours ago4.Enabling patients to be provided with free at‐home telehealth dialysis Aetna & Unison) 99281‐99285 99251‐99255 Critical Care 0188T, 0189T (Aetna & Health 4 “procedure code is inconsistent with the modifier used or a required modifier is missing.”

Link: https://news.choosehealthde.com/wp-content/uploads/2018/12/DE-Telehealth-Learning-Lab_Reimbursement-and-Payment_1.18.19.pdf

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FAQs for Illinois Medicaid Virtual Healthcare Expansion

FAQs Www2.illinois.gov Get All

6 hours agoprovider may instead seek reimbursement for virtual check-in services using CPT code G2012, which also requires POS 02 and modifier GT. What are the dental telehealth codes? For teledentistry, dental providers should bill HCPCS codes D9995 or D9996 - along with D0140 - in accordance with the HCPCS code

Link: https://www2.illinois.gov/hfs/SiteCollectionDocuments/FINALTelehealthRulesChangeFAQs03302020.pdf

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Aetna and Telehealth: Questions and Answers Gawenda Seminars

and Gawendaseminars.com Get All

1 hours agoDue to the COVID-19 Pandemic, Aetna has expanded telehealth services to include outpatient physical, occupational and speech therapy services. In this article, I will answer some of the more common questions I have received regarding Aetna’s expansion of telehealth services to include physical, occupational and speech therapy services. QuestionWhen did Aetna expand telehealth services to […]

Link: https://gawendaseminars.com/aetna-and-telehealth-questions-and-answers/

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The 27 telehealth services Aetna covers during COVID19

The Beckershospitalreview.com Get All

5 hours agoMembers will not have to pay co-pays for any telemedicine visits through June 4 and Aetna has waived cost-sharing for all virtual visits. Here is a guide to covered visits and their codes.

Link: https://www.beckershospitalreview.com/telehealth/the-27-telehealth-services-aetna-covers-during-covid-19-and-their-codes.html

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PLAN BY PLAN COVERAGE FOR TELEHEALTH IN RESPONSE TO …

PLAN Theinsurancemaze.com Get All

8 hours agoProviders should bill established-patient evaluation and management codes up to a level 3 (CPT codes 99211, 99212 and 99213). Standard documentation applies and additional billing guidelines will be posted on ProviderAccess. Claims should be filed with place of service 02 (telehealth). A modifier

Link: https://theinsurancemaze.com/telehealthpolicies/

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Frequently Asked Questions

What is the place of service code for Aetna?

Aetna Telehealth Billing & Coding Guidelines CPT Code: Utilize the most accurate CPT code possible. Place of Service Code: 02 Aetna Telehealth Modifier: 95

How does Aetna reimburse providers for telemedicine services?

In most cases, Aetna reimburses providers for telemedicine services, including behavioral health services, at the same rate as in-person visits.

What is the place of service code for telehealth?

When billing telehealth services, healthcare providers must bill the E&M code with place of service code 02 along with a GT or 95 modifier. Telehealth services not billed with 02 will be denied by the payer. This is true for Medicare or other insurance carriers. Know how to bill a facility fee

What is the correct insurance modifier for telehealth billing?

The correct insurance billing modifier to use for telehealth billing for therapists depends on the guidelines of the insurance company you’re billing. We’ll cover the four telehealth modifiers for insurance billing with an emphasis on the two most popular codes, “95” and “GT”.

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