Place of Service
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I do not accept insurance.  I am adding -95 to my CPT codes.  I have added telehealth as a place of service in my practice settings, but I do not see how to include or change place of service in the actual appointments, invoices, superbills etc. (1) How do I do that? (2) Is including place of service necessary if I do not accept insurance?  I have never included it before.  Thank you. 

 

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    Gillian

    Hi Laelia, I'd be happy to help. Under My Account > Settings > Practice Details, you can select the Insurance Place of Service code associated with sessions held via video. The 02 Place of Service code will automatically populate onto your courtesy claims and Superbills when the appointment is scheduled at that location. 

    Hi Laelia, I'd be happy to help. Under My Account > Settings > Practice Details, you can select the Insurance Place of Service code associated with sessions held via video. The 02 Place of Service code will automatically populate onto your courtesy claims and Superbills when the appointment is scheduled at that location. 

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    Michelle Heller

    How can I change place of service for prior visits?

     

    How can I change place of service for prior visits?

     

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    Gillian

    Hi Michelle, happy to help. To change the Location of previous sessions, you can click the past session on your Calendar and select a different  Location from the drop-down menu. Hit Save to save your changes. Please note that you'll need to delete and recreate any Superbills or billing documents associated with these sessions to update them with the new Location information. 

    Hi Michelle, happy to help. To change the Location of previous sessions, you can click the past session on your Calendar and select a different  Location from the drop-down menu. Hit Save to save your changes. Please note that you'll need to delete and recreate any Superbills or billing documents associated with these sessions to update them with the new Location information. 

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    Seth Chapman

    I have followed these instructions but still do not see The 02 Place of Service code on my Superbill statements. Where should it appear?

    I have followed these instructions but still do not see The 02 Place of Service code on my Superbill statements. Where should it appear?

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    Gillian

    Hi Seth, happy to help. It will appear right after the CPT code for the appointment. Make sure to delete and recreate the Superbill after reassigning the location of the past appointments on your Calendar to ensure the Place of Service code is appropriately recorded on your Superbills. 

    Hi Seth, happy to help. It will appear right after the CPT code for the appointment. Make sure to delete and recreate the Superbill after reassigning the location of the past appointments on your Calendar to ensure the Place of Service code is appropriately recorded on your Superbills. 

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    Kaye-Ailsa Rowan

    How do we make our billing address appear on the superbill? When I define Place of Service as telehealth, the location code is correct (yes!). However, my telehealth address is appearing at the *top* of the Superbill instead of my mailing address.

    How do we make our billing address appear on the superbill? When I define Place of Service as telehealth, the location code is correct (yes!). However, my telehealth address is appearing at the *top* of the Superbill instead of my mailing address.

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    Gaaren Anderson

    I have received instructions from my biller (BluBird Billing--Dylan) that we are to switch back to having Place of Service for TeleHealth say "11-Office"  instead of "02-TeleHealth". 

    Is that instruction coming from SP? If so, I've encountered what seems like a "You can't get there from here."  scenario.  Whenever I switch to 11-Office, it eliminates all links for starting a TeleHealth session.  I don't see a way of having 11-Office as Place of Service unless I go to an outside service for TeleHealth (like WebEx, or something).  

    Are his instructions correct?  

    Am I missing something?

    Instructions?

    I have received instructions from my biller (BluBird Billing--Dylan) that we are to switch back to having Place of Service for TeleHealth say "11-Office"  instead of "02-TeleHealth". 

    Is that instruction coming from SP? If so, I've encountered what seems like a "You can't get there from here."  scenario.  Whenever I switch to 11-Office, it eliminates all links for starting a TeleHealth session.  I don't see a way of having 11-Office as Place of Service unless I go to an outside service for TeleHealth (like WebEx, or something).  

    Are his instructions correct?  

    Am I missing something?

    Instructions?

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    Chanelle Noyes

    I'm not seeing an option to change our place of service when creating an appointment.  How can we do this if it's not showing up next to the CPT code?

    I'm not seeing an option to change our place of service when creating an appointment.  How can we do this if it's not showing up next to the CPT code?

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    Gaaren Anderson

    @Chanelle N.---To make another office location for TeleHealth, or a different physical officego to Settings>Practice Details>Office Locations & click on  (+ Office) . 

    It will not show up in the CPT code--these are different fields.  Office Location is WHERE the service is delivered (1234 Main Street, Waco, Texas  or  4321 Ocaw, Arkansas,  or TeleHealth).  The CPT code is a billing Code for HOW the service was delivered.   (ie.,  90791=Intake, 90834=Individual psychotherapy, 90847=conjoint/family therapy with patient present).  To complicate matters more, they have added "Modifiers" to the CPT Code (ie 90834-95 = Individual psychotherapy delivered through TeleHealth. 

    To make matters worse, I've been instructed that Regence uses "GT" instead of "95", and CIGNA has no modifier.  So---it does make sense, but there is alot to keep track of.

     

    @Chanelle N.---To make another office location for TeleHealth, or a different physical officego to Settings>Practice Details>Office Locations & click on  (+ Office) . 

    It will not show up in the CPT code--these are different fields.  Office Location is WHERE the service is delivered (1234 Main Street, Waco, Texas  or  4321 Ocaw, Arkansas,  or TeleHealth).  The CPT code is a billing Code for HOW the service was delivered.   (ie.,  90791=Intake, 90834=Individual psychotherapy, 90847=conjoint/family therapy with patient present).  To complicate matters more, they have added "Modifiers" to the CPT Code (ie 90834-95 = Individual psychotherapy delivered through TeleHealth. 

    To make matters worse, I've been instructed that Regence uses "GT" instead of "95", and CIGNA has no modifier.  So---it does make sense, but there is alot to keep track of.

     

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    Gaaren Anderson

    In relation to my previous entry (third one up from here)--SP does not allow me to set Office Location to anything other than Video Office, and still bring up the links to start a session--apparently programming that has not kept up with the rapidly changing COVID & insurance situation.    The work-around that I have found is to schedule it with Location = Video Office, then after the appointment, change Office Location to the physical office.

    In relation to my previous entry (third one up from here)--SP does not allow me to set Office Location to anything other than Video Office, and still bring up the links to start a session--apparently programming that has not kept up with the rapidly changing COVID & insurance situation.    The work-around that I have found is to schedule it with Location = Video Office, then after the appointment, change Office Location to the physical office.

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    Andrew S. Greer

    Same question:  Medicare requires  11 Office + 95 for Telehealth.  How does one set this up in SP?   Gaaren A. solution would work, but there needs to be Telehealth 11 office setting in practice location.  When working with several insurers some require 02 for Telehealth and some 11.  Especially important in the Covid-19 universe. 

    Same question:  Medicare requires  11 Office + 95 for Telehealth.  How does one set this up in SP?   Gaaren A. solution would work, but there needs to be Telehealth 11 office setting in practice location.  When working with several insurers some require 02 for Telehealth and some 11.  Especially important in the Covid-19 universe. 

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    Gaaren Anderson

    SP just sent out eMail with instructions on how to setup Modifiers. You can setup defaults for each client at bottom of Edit>Billing & Insurance>Client Default Services.  Client Default Office is at   Edit>Client Info>Location.

    My understanding from my biller (Dylan):  told me to put Location at physical office location for everyone and use the modifiers to identify it as telehealth delivery, but you say that some require some to be physical office, and some say it has to be Video Office.  Where are you getting that from?  and if it is so, which ones require each? 

    Maybe SP/Gillian could clarify?

    SP just sent out eMail with instructions on how to setup Modifiers. You can setup defaults for each client at bottom of Edit>Billing & Insurance>Client Default Services.  Client Default Office is at   Edit>Client Info>Location.

    My understanding from my biller (Dylan):  told me to put Location at physical office location for everyone and use the modifiers to identify it as telehealth delivery, but you say that some require some to be physical office, and some say it has to be Video Office.  Where are you getting that from?  and if it is so, which ones require each? 

    Maybe SP/Gillian could clarify?

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    Andrew S. Greer

    I am in California.  From the APA, Medicare asks for Office + 95 modifier.  Anthem Blue Cross of California,  Blue Shield of California  ask for Telehealth 02 + 95 modifier and Partnership/Beacon (northern California) requires Telehealth 02 + GT modifier.  This information was obtained from American Psychological Association for Medicare and  NCAMHP (North Coast Associaton of Mental Health Professionals, Anthem, Blue Shield and Partnership/Beacon directly).  Hope this helps.  Please check you local payor requirements as I am only providing information for Northern California. 

    I am in California.  From the APA, Medicare asks for Office + 95 modifier.  Anthem Blue Cross of California,  Blue Shield of California  ask for Telehealth 02 + 95 modifier and Partnership/Beacon (northern California) requires Telehealth 02 + GT modifier.  This information was obtained from American Psychological Association for Medicare and  NCAMHP (North Coast Associaton of Mental Health Professionals, Anthem, Blue Shield and Partnership/Beacon directly).  Hope this helps.  Please check you local payor requirements as I am only providing information for Northern California. 

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    Ruth

    Hello - Thank you all for contributing to this thread and engaging on our Community Forum. I've answered your questions below:

    Yes, some payers are requiring you to use the Place of Service 11 (Office) instead of 2 (Video Office) during this pandemic; however, the rules on this vary and I'd suggest you check with the insurance payer before billing. 

    Also, check out our comprehensive guide on Billing Insurance for Telehealth Appointments. 

    In terms of changing your Telehealth Place of Service from 2-Video Office, to 11-Office Location, you will be able to make this change in My Account > Settings > Practice Details. Scroll down to the bottom of the page to find the Office Name: Video Office and change the location marker by using the dropdown menu, pictured here:  

    When you make this change it will be applied to all your Telehealth sessions; therefore, you'll need to manually edit claims individually for payers that still require the 2-Video Office demarcation. You can use the dropdown menu to manually edit box 24b. on a claim for these insurance payers. Here is a screenshot:

     

    For modifiers (95, or GT) you can enable our recent feature enhancement that auto-populates modifiers onto claims by going to My Account > Settings > Billing and Services > Insurance. Check the box to enable modifiers for your practice. Here is more information on how to add default modifiers to your clients' set default service codes, to particular appointments from the Calendar, or from your clients' billing page: How do I add modifiers to claims?

    Setting a Telehealth location marker (as 2 or 11), adding modifiers (95 or GT) and being able to access Telehealth session links are not connected. They're all independent functions within the system and one won't affect the others. 

    Please let me know if there is anything else I can further clarify, or if I missed anything. 

    Thank you again for being part of the SimplePractice Community. 

    Edited by Ruth

    Hello - Thank you all for contributing to this thread and engaging on our Community Forum. I've answered your questions below:

    Yes, some payers are requiring you to use the Place of Service 11 (Office) instead of 2 (Video Office) during this pandemic; however, the rules on this vary and I'd suggest you check with the insurance payer before billing. 

    Also, check out our comprehensive guide on Billing Insurance for Telehealth Appointments. 

    In terms of changing your Telehealth Place of Service from 2-Video Office, to 11-Office Location, you will be able to make this change in My Account > Settings > Practice Details. Scroll down to the bottom of the page to find the Office Name: Video Office and change the location marker by using the dropdown menu, pictured here:  

    When you make this change it will be applied to all your Telehealth sessions; therefore, you'll need to manually edit claims individually for payers that still require the 2-Video Office demarcation. You can use the dropdown menu to manually edit box 24b. on a claim for these insurance payers. Here is a screenshot:

     

    For modifiers (95, or GT) you can enable our recent feature enhancement that auto-populates modifiers onto claims by going to My Account > Settings > Billing and Services > Insurance. Check the box to enable modifiers for your practice. Here is more information on how to add default modifiers to your clients' set default service codes, to particular appointments from the Calendar, or from your clients' billing page: How do I add modifiers to claims?

    Setting a Telehealth location marker (as 2 or 11), adding modifiers (95 or GT) and being able to access Telehealth session links are not connected. They're all independent functions within the system and one won't affect the others. 

    Please let me know if there is anything else I can further clarify, or if I missed anything. 

    Thank you again for being part of the SimplePractice Community.