Billing Insurance providers for video sessions
AnsweredHello, 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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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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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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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
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I have added the 02 and 95 modifier for Aetna and STILL the claims are rejected. Is there another code needed elsewhere? Or should I call Aetna to understand what is happening? Thanks so much - Simple Practice makes this all so much easier than if I were generating these claims myself!
Suki
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For what it's worth, I've had decent luck calling Aetna last week and earlier today. They have not been processing claims to include the copays so I've had the agents send back claims for 5 clients. They said that my original claims did not have the telehealth codes, which they did. I'm actually having to mail in a claim today. I would call Aetna. Good luck!
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