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Telepsychiatry Billing

Telepsychiatry Billing

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Published by WorldEventsForum
Presentation made by Mindy Burchard at the April 22, 2013 live Webinar: http://worldeventsforum.blogspot.com/p/l-ive-event-will-be-held-thursday-march.html
Presentation made by Mindy Burchard at the April 22, 2013 live Webinar: http://worldeventsforum.blogspot.com/p/l-ive-event-will-be-held-thursday-march.html

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Published by: WorldEventsForum on Apr 23, 2013
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08/28/2015

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Does Medicare pay for TelePsychiatry?

Yes, Medicare guidelines state “The use of telecommunications systems may substitute for a face-toface, “hands-on” encounter.” However, the facility must be located outside of a major metropolitan area or in a Mental Health Professional Shortage Area (HPSA).

Does Managed Care pay for TelePsychiatry? Sometimes. Many managed care companies follow Medicare guidelines others have their own rules or do not pay at all. .

What can be billed? There are two possible levels of billing for TelePsychiatry Services: • The actual services provided • The “originating site” .

BILLING FOR SERVICES PROVIDED As a condition of payment.Billing for the actual services provided is done by the clinician who is treating the patient. The usual and customary CPT codes are used but a special modifier is added to the claim to indicate the interactive telemedicine component. the video conferencing system used must permit “real-time” communication between the provider and patient. . No more than one service per month is covered. They bill Medicare or the appropriate payer for their services.

Physician’s offices Authorized Originating Site locations include: Skilled Nursing Facilities BILLING FOR the ORIGINATING SITE An originating site is the location of an eligible Medicare beneficiary at the time the service is furnished via TelePsychiatry. the Q code pays around $19.The location must be located outside of a major metropolitan care or in a designated HPSA area specific to mental health. Managed care and secondary payers typically do not reimburse for the originating site.00. Companies like ours can bill these on you behalf or you can bill for the originating site yourself if your facility is set up to bill for Medicare Part B services . The originating site fee (CPT Q code) is billed independent of the billable service. ALFs do not qualify For those residents with Medicare Part B coverage.

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