Telehealth Modifier Codes
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What progress is SimplePractice making toward a functionality that will auto-populate telehealth modifier codes on claims? 

6 comments

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    Diana Goldstein

    This was supposed to happen this past week, but it hasn't.  I put the 95 modifier into all my clients' 'billing' sections, but still have to manually enter 95 in all of my claims which is a pain.  I hope this is soon resolved.

    This was supposed to happen this past week, but it hasn't.  I put the 95 modifier into all my clients' 'billing' sections, but still have to manually enter 95 in all of my claims which is a pain.  I hope this is soon resolved.

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    Sabrina Umphress

    The Simple Practice instructions which were emailed with the notification that they created the modifier fields in the calendar pop up window explain that you enable this feature in settings.  I followed the instructions and now the modifier fields appear:

    You’ll be able to enable Modifiers by navigating to My Account > Billing and Services > Insurance > Modifiers. Once Modifiers are enabled, you’ll have two ways to add modifiers:

    1. Quickly add modifiers from the calendar by clicking a specific appointment.

    2. Set a default service code and modifier for a client on their Billing and Insurance Settings page so it applies to all of their appointments moving forward.

    The Simple Practice instructions which were emailed with the notification that they created the modifier fields in the calendar pop up window explain that you enable this feature in settings.  I followed the instructions and now the modifier fields appear:

    You’ll be able to enable Modifiers by navigating to My Account > Billing and Services > Insurance > Modifiers. Once Modifiers are enabled, you’ll have two ways to add modifiers:

    1. Quickly add modifiers from the calendar by clicking a specific appointment.

    2. Set a default service code and modifier for a client on their Billing and Insurance Settings page so it applies to all of their appointments moving forward.

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    Diana Goldstein

    Yes, I did all that, and the default modifiers are in my clients' billing section.  It does not auto-populate on the CMS-1500 claim form.  Your reply above fails to address this not happening, which would appear to be a coding or programming issue.

    Yes, I did all that, and the default modifiers are in my clients' billing section.  It does not auto-populate on the CMS-1500 claim form.  Your reply above fails to address this not happening, which would appear to be a coding or programming issue.

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    David B. Shaw

    I would check to see if the modifier is not showing up on the appointment screen for recurring appointments. You may have to change it there and indicate the change is for all future appointments.

    I would check to see if the modifier is not showing up on the appointment screen for recurring appointments. You may have to change it there and indicate the change is for all future appointments.

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    Sharon Coulter

    I have turned modifiers on in settings. However, when I go to the appointment in the calendar, I do not see how to select the modifier. Where from/how do I select it.? Thanks!

    I have turned modifiers on in settings. However, when I go to the appointment in the calendar, I do not see how to select the modifier. Where from/how do I select it.? Thanks!

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    Ruth

    Hi All - I can certainly clarify this for you. 

    The first step, as many of you have done, is enabling modifiers by going to My Account > Settings > Billing and Services > Insurance. 

    Here are three ways you can add Telehealth modifiers to your service codes:

    Option 1:

    You can add modifiers to an appointment from your Calendar

    • To do this, click on the Calendar and click on the appointment
    • Add the modifier in one of the blank text boxes under the service 

    Here is a screenshot in my test account: 


    Option 2:

    You can also add a modifier from a client's Billing page

    • Go to the client's file, click the Billing tab 
    • Click on the bolded "Appointment" for the session you'd like to add a modifier for 
    • Add the modifier bellow the service code

    Here is a screenshot in my test account:

    Option 3:

    You can also add a modifier to your client's default service code, to be applied to all sessions you schedule with them in the future. 

    • To do this, go to the client's file, click Edit under the client's name, click on the Billing and Insurance tab
    • Now scroll to the very bottom of the page and add a default service under Client Default Services
    • Add a modifier to this service

    Here is a screenshot: 

     

    Note: Adding a modifier to a client's Default Service won't change any previously scheduled appointments. Use one of the other two methods to retroactively add a modifier. 

    Lastly, you can manually add a modifier to a claim that's already been created, before you submit it to the insurance payer. 

    For more information on the various ways you can add a modifier, please check out our guide: How do I add modifiers to my claims?

    Hi All - I can certainly clarify this for you. 

    The first step, as many of you have done, is enabling modifiers by going to My Account > Settings > Billing and Services > Insurance. 

    Here are three ways you can add Telehealth modifiers to your service codes:

    Option 1:

    You can add modifiers to an appointment from your Calendar

    • To do this, click on the Calendar and click on the appointment
    • Add the modifier in one of the blank text boxes under the service 

    Here is a screenshot in my test account: 


    Option 2:

    You can also add a modifier from a client's Billing page

    • Go to the client's file, click the Billing tab 
    • Click on the bolded "Appointment" for the session you'd like to add a modifier for 
    • Add the modifier bellow the service code

    Here is a screenshot in my test account:

    Option 3:

    You can also add a modifier to your client's default service code, to be applied to all sessions you schedule with them in the future. 

    • To do this, go to the client's file, click Edit under the client's name, click on the Billing and Insurance tab
    • Now scroll to the very bottom of the page and add a default service under Client Default Services
    • Add a modifier to this service

    Here is a screenshot: 

     

    Note: Adding a modifier to a client's Default Service won't change any previously scheduled appointments. Use one of the other two methods to retroactively add a modifier. 

    Lastly, you can manually add a modifier to a claim that's already been created, before you submit it to the insurance payer. 

    For more information on the various ways you can add a modifier, please check out our guide: How do I add modifiers to my claims?