Billing Insurance providers for video sessions
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Hello, I am now seeing all of my clients in Simple Practice video sessions. Can you tell me what CPT code and Place of Service code to use for sessions. Is there a different session duration that can be billed for video sessions?

Dr. Collins

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    Logan Foley

    Linda,

    I am in the same boat trying to understand all of this.  Will start billing teletherapy this week.

    I will try and provide my 2 cents here.  Anyone more educated on the topic please correct me if I am wrong.

    As an LPC, I will continue to utilize codes such as 90791 ,90837, 90834, etc for synchronous 2 way video sessions.  So no difference in CPT codes that I am aware of.

    As I understand it, most providing behavioral health services will use the modifier "95" in box 24 D of the claim form with a place of service in box 24 B of "02".  

    Perhaps Gillian or someone who already has experience billing teletherapy can help us out here.

    Logan

    Linda,

    I am in the same boat trying to understand all of this.  Will start billing teletherapy this week.

    I will try and provide my 2 cents here.  Anyone more educated on the topic please correct me if I am wrong.

    As an LPC, I will continue to utilize codes such as 90791 ,90837, 90834, etc for synchronous 2 way video sessions.  So no difference in CPT codes that I am aware of.

    As I understand it, most providing behavioral health services will use the modifier "95" in box 24 D of the claim form with a place of service in box 24 B of "02".  

    Perhaps Gillian or someone who already has experience billing teletherapy can help us out here.

    Logan

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    Gillian

    Thanks, Logan, for providing this information. You are correct - in almost all cases, you'll use the same CPT code to bill Telehealth that you would for in-office sessions. You'll need to adjust the Insurance Place of Service location to 02 for Telehealth (this is done automatically if you use SimplePractice's integrated Telehealth platform), as well as a 95 or GT modifier in box 24D, depending on the payer. 

    Thanks, Logan, for providing this information. You are correct - in almost all cases, you'll use the same CPT code to bill Telehealth that you would for in-office sessions. You'll need to adjust the Insurance Place of Service location to 02 for Telehealth (this is done automatically if you use SimplePractice's integrated Telehealth platform), as well as a 95 or GT modifier in box 24D, depending on the payer. 

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    Jennifer Bean

    Is the 95 modifier also automatic if I'm using SimplePractice's integrated Telehealth platform?

    Is the 95 modifier also automatic if I'm using SimplePractice's integrated Telehealth platform?

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    Jennifer Bean

    Nevermind! You answered this under a different topic. Sorry!

    Nevermind! You answered this under a different topic. Sorry!

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    Jennifer Bean

    And, sorry Again. I'm not used to posting here. It wasn't answered actually.  Do I need to go through and change each claim? I just tried generating a telehealth claim, and while the POS was changed to 02, the modifier of 95 was not automatically generated.  How do I turn this on?

    And, sorry Again. I'm not used to posting here. It wasn't answered actually.  Do I need to go through and change each claim? I just tried generating a telehealth claim, and while the POS was changed to 02, the modifier of 95 was not automatically generated.  How do I turn this on?

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    Diana Goldstein

    I'm following this thread, I've had several Aetna telehealth claims rejected because of lack of modifier, and I would like GT or 95 turned on automatically, so I don't have to manually go into each claim.  Help, Simple Practice!!

     

    I'm following this thread, I've had several Aetna telehealth claims rejected because of lack of modifier, and I would like GT or 95 turned on automatically, so I don't have to manually go into each claim.  Help, Simple Practice!!

     

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    Gillian

    Hi Jennifer, happy to clarify. The 95 or GT modifier isn't added automatically, so you'll want to create the claim, edit it, and enter the modifier manually. We're actively working on automating this process - you can vote for the idea to subscribe to updates on our Ideas board here: https://simplepractice.uservoice.com/forums/918553/suggestions/36554008

    Hi Jennifer, happy to clarify. The 95 or GT modifier isn't added automatically, so you'll want to create the claim, edit it, and enter the modifier manually. We're actively working on automating this process - you can vote for the idea to subscribe to updates on our Ideas board here: https://simplepractice.uservoice.com/forums/918553/suggestions/36554008