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Insurance billing - telehealth place of service

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6 comments

  • William Horn

    Hi Carie,

    I just received a denial on one of my pt's insurance submission in which the place of service for telehealth on my Simple Practice generated bill is indicated by (02).

    I am interested in clarification regarding this issue as well.

    Would appreciate hearing from others as well regarding their experience with this issue

     

    Many thanks,

     

    William H.

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  • Patricia B. Jones

    Yes, you need to use the Mod 95 for telehealth. I just do not know how to make this automatic so I do not need to change each claim every time.

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  • William Horn

    Patricia,

    Thank you for your response. Do you know how to change it on single claim vs making it automatic?

     

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  • Gillian

    Hi Patricia and William, I'd be happy to help. Insurance payers often differ regarding what coding they prefer for Telehealth sessions - some ask that the 02 place of service code is listed, whereas others ask for a GT or 95 modifier. The best source of information for how to code insurance sessions is always the payer. 

     

    To add a modifier automatically to all of a client's sessions, go to Edit on their Overview page, then Billing and Services. At the bottom of the page, you can add a default service and modifier for that service. That way, if different payers require different modifiers, you can customize which modifier is associated with each client. 

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  • Caley O'Dwyer

    Gillian, thanks for your help. When I follow your instructions above I do come to the area at bottom of client "Billing and Services" page, and while I see how to add additional services in general, I don't see a way to add a modifier in particular. For example, I'd like to add the 95 telehealth modifier to a 90834 Psychotherapy, 45 min service but I don't see a way to add that modifier. Should it appear in the "select to add new service" drop down menu? Maybe I'm overlooking it??

    Thanks!!

    Caley 

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  • Ayelette

    Hi Caley,

    I'm happy to clarify this.

    To enable the practice wide option to add default modifiers to a client's profile, go to Settings > Billing and Services > Insurance > select Enable Modifiers for your practice > click Save.

    After that practice wide setting is enabled, you'll see an option on each client's Edit > Billing and Insurance page to add a default service code modifier.

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