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Tricare updates Tele-Health billing procedures

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5 comments

  • Edna Cydne Collins

    Bills with the 02 site code are being rejected.  How can I insure the 011 code is on the billing forms without editing each form?

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  • Ruth

    Hi Edna, you can change the Insurance Place of Service for your Telehealth Office Location by going to Settings > My Practice > Edit and use the dropdown menu to pick 11-Office. 

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  • Mei Hua-Burns

    Does Tricare East also take this 11/95? Can you post a link to where Tricare announced this change? I can't find it anywhere. 

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  • Wendy Belding

    Hi,

    Tricare East uses Humana.  Here's a page [ https://www.humanamilitary.com/provider/education-and-resources/quick-access/telemedicine ] that leads to this document: [ https://docushare-web.apps.cf.humana.com/Marketing/docushare-app?file=3924427 ].

    How do I bill for telemedicine services?

    Please refer provider to policy for applicable CPT codes.

    Synchronous* telemedicine services will use CPT or HCPCS codes with a GT modifier for distant site and Q3014 for an applicable originating site to distinguish telemedicine services. Also, Place of Service “POS 02” is to be reported in conjunction with the GT modifier.

    Asynchronous* telemedicine services will use CPT or HCPCS codes with a GQ modifier.

    When submitting claims for telemedicine services, the provider may indicate “Signature not required-distance telemedicine site” in the required patient signature field.

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  • Mei Hua-Burns

    Hi Wendy, both of the documents you posted reference Place of Service “POS 02” when billing Telehealth. I do not see anywhere that says we can use "11-Office" POS as stated in your original post.

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