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Appt TypeCPT CodesModifiersPlace of ServiceBilling Facility SelectionAdditional NotesWebsite
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All this information is as of 03/25/2020 10 AM. Rules may change, for some payers the telehealth services may extend beyond the DOS listed.
3/28/2020 - Updated NC Medicaid and Cigna
4/25/2020 - updated BCBS valid date and Tricare info
4/28/2020 -updated Aetna modifiers
4/29/2020 - updated CR modifier for phone only visit for BCBS; updated UHC POS from 02 to 11
5/9/2020 - updated POS = 11 for NC Medicaid and for Medicare
5/29/2020 updated, Aetna, Cigna Telehealth allowed date
06/25/2020 - updated the end dates for many payers
07/30/2020 - updated Cigna, AL Medicaid TM allowed dates
02/01/2021 - updated UHC POS back to 02 for DOS 01/01/2021 later
02/10/2021 - Added Florida Healthcare Plan
04/27/2021 - Udated IN Anthem coding
04/28/2021 - updated IN Medicaid coding
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MedicareTelemedicine ConsultE&M Codes 99201 - 99205 and 99211-99215, 99406, 994079511Practice Location Nameyou may find other codes that can be billed like 99406, 99407https://www.cms.gov/outreach-and-educationoutreachffsprovpartprogprovider-partnership-email-archive/2020-04-03-mlnc-se
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Telemedicne Phone ConsultG2012 and G2010N/A02Telemedicineonly for established patients. New Patients cannot be billed with these codes.
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Telemedicine Phone Consult99421, 99422, 99423 and G2061, G2062, G2063N/A02TelemedicineThese codes can be used only when patient used patient portal to communicate with the provider https://www.cms.gov/newsroom/fact-sheets/medicare-telemedicine-health-care-provider-fact-sheet
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3/28/2020 - Cigna - updated as per the update email received
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Cigna (DOS - Tele health allowed prior to 12/31/2020)

Telemedicine ConsultTelemedicine N/A
GQ		02
11		Telemedicine
Practice Location Name		Please check enc summ to see if its Phone only encounter -- where th patient could not do Video encounter -- if its mentioned that only phone call was made - then follow the coding rules for Telmedicine Phone Consulthttps://static.cigna.com/assets/chcp/resourceLibrary/medicalResourcesList/medicalDoingBusinessWithCigna/medicalDbwcCOVID-19.html
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Telemedicne Phone ConsultE&M Codes 99211-99215GQ11Practice Location Namehttps://static.cigna.com/assets/chcp/secure/pdf/resourceLibrary/clinReimPolsModifiers/Notifications/R31_Virtual_Care.pdf
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Any Appt but Telemedicine was used99241 N/A11Practice Location Nameif Dx is Z03.818 or Z20.828 -- there will be no copay
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Telemedicne Phone ConsultG2012 N/A02Telemedicine if Dx is Z03.818 or Z20.828 -- there will be no copay
Any phone consult to screen if Covid or not
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4/28/2020 updated modifiers as per Aetna update on 4/17/2020
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Aetna (DOS - Tele health allowed prior to 09/30/2020)Telemedicine ConsultE&M Codes 99211-99215GT or 9502Telemedicine Recognized Dx codes for Covid-19 symptoms: J12.89, B97.29, J20.8, B97.29, J40, B97.29, J22, B97.29, J98.8,B97.29, J80, B97.29, Z03.818, Z20.828, R05, R06.02, R50.9
B34.2 (Coronavirus infection, unspecified) would in general not be appropriate for the COVID-19,
If the provider documents “suspected”, “possible” or “probable” COVID-19, do not assign code B97.29. Assign a code(s) explaining the reason for encounter (such as fever, or Z20.828).		https://www.aetna.com/health-care-professionals/provider-education-manuals/covid-faq.html#acc_link_content_section_responsivegrid_copy__responsivegrid_accordion_9
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Aetna Medicare - Telemedicine ConsultE&M Codes 99211-992159502
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Telemedicine Consult99421, 99422, 99423N/A02Telemedicine Needs both audio and Video
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Telemedicne Phone ConsultG2012 or G2010N/A02Telemedicine if Dx is Z03.818 or Z20.828 -- there will be no copay
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Telemedicne Phone Consult [By non provider]99441, 99442, 99443Telemedicine
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4/29/2020 - changed POS to 11 [or the regular place of servie the practice typically uses]
02/01/2020 - changed POS to 02 -- applied to claims DOS 1/1/2021 and later
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UHC (DOS - prior to 09/30/2020)
Telemedicine ConsultE&M Codes 99211-99215 and 99201-99205no need to add a mod for 2021
95 [2020 visit]
02Practice Location NamePlease check enc summ to see if its Phone only encounter -- where th patient could not do Video encounter -- if its mentioned that only phone call was made - then follow the coding rules for Telmedicine Phone Consulthttps://www.uhcprovider.com/en/resource-library/news/provider-telehealth-faqs.html
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Telemedicne Phone ConsultG2012 and G2010N/A11Practice Location Nameonly for established patients. New Patients cannot be billed with these codes.https://www.uhcprovider.com/content/provider/en/viewer.html?file=%2Fcontent%2Fdam%2Fprovider%2Fdocs%2Fpublic%2Fresources%2Fnews%2F2020%2FTelehealth-Patient-Scenarios.pdf
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Telemedicine Phone Consult99421, 99422, 99423 and G2061, G2062, G2063N/A11Practice Location NameThese codes can be used only when patient used patient portal to communicate with the provider https://www.uhcprovider.com/en/resource-library/news/Novel-Coronavirus-COVID-19/covid19-telehealth-services/covid19-telehealth-services-telehealth.html
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Humana (DOS - prior to 12/31/2020)
Telemedicine ConsultE&M Codes 99211-99215 and 99201-99205N/A02Telemedicine **we may need GT or 95 as needed. No proper guidance provided at this timehttps://www.humana.com/provider/coronavirus/telemedicine
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Telemedicne Phone ConsultG2012 and G2010N/A02Telemedicine only for established patients. New Patients cannot be billed with these codes.
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Telemedicine Phone Consult99421, 99422, 99423 and G2061, G2062, G2063N/A02TelemedicineThese codes can be used only when patient used patient portal to communicate with the provider Follows cms & state specific guidelines
https://www.cchpca.org/covid-19-related-state-actions
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04/27/2021 -- Added modifiers as per website
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Anthem (DOS - prior to 09/30/2020)

No clear coding guideline provided. Follow CMS guidelines 		Telemedicine ConsultE&M Codes 99201 - 99205 and 99211-9921595 or GT02Telemedicine https://providernews.anthem.com/indiana/article/information-from-anthem-for-care-providers-about-covid-19-6
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Telemedicne Phone Consult99441, 99442, 99443, 98966, 98967, 98968
G2012 and G2010		N/A02Telemedicine only for established patients. New Patients cannot be billed with these codes.
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Telemedicine Phone ConsultN/A02TelemedicineThese codes can be used only when patient used patient portal to communicate with the provider https://www.anthem.com/coronavirus/providers/
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03/28/2020 -NC Medicaid - updated the telephone visit codes depending on whether the patient was seen in last 7 days at the office;
4/26/2020 - fixed Phone modifiers
5/9/2020 - changed POS to 11.
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NC Medicaid (through the conclusion of the State of Emergency related to COVID-19)Telemedicine ConsultE&M Codes 99201 - 99205 and 99211-99215GT, CR11Practice Location Namehttps://medicaid.ncdhhs.gov/blog/2020/03/20/special-bulletin-covid-19-9-telehealth-provisions-clinical-policy-modification
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Telemedicine Consult - Consultation Codes99241,99242,99243,99244,99245,99251,99252,99253,99254,99255GT, CR11Practice Location Name
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Telemedicine Consult [FQHC]T1015GT, CR11Practice Location Name
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Telemedicine Consult - Psych [FQHC]T1015HI, GT,CR11Practice Location Name
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Telemedicne Phone Consult [FQHC]G0071CR11Practice Location NameNC Medicaid removed the need for GT modifier on phone only claims.
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Telemedicne Phone ConsultG2012 - Covid related screeningCR11Practice Location Namehttps://files.nc.gov/ncdma/covid-19/NCMedicaid-Telehealth-Billing-Code-Summary.pdf
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Telemedicne Phone Consult99421, 99422, 99423 - If patient was seen at the office in last 7 daysCR11Practice Location Name
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Telemedicne Phone Consult99441, 99442, 99443 - If patient was not seen at the office in last 7 days CR11Practice Location Name
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Florida Blue (DOS - prior to 09/30/2020)Telemedicine ConsultE&M Codes 99201 - 99205 and 99211-992159502Telemedicine https://www.floridablue.com/providers/covid-19-information
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No specific information available on Phone calls onlyhttps://www.floridablue.com/sites/floridablue.com/files/docs/COVID-19_Update_June_2020_101948-0620_06.25.20_Approved_0.pdf
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TriWest [VA] - Providers must have an authorization on file before proceeding with telehealth careTelemedicine ConsultE&M Codes 99201 - 99205 and 99211-99215GT02Telemedicine follow CMS guidelines and check the latest in the link providedhttp://www.triwest.com/globalassets/vapc3-provider-files/quick-reference-guides/tele-health_qrg.pdf
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04/28/2021 - updated modifer to be 95; POS = 02
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IN MedicaidTelemedicine ConsultE&M Codes 99201 - 99205 and 99211-99215GT02Practice Location Namehttp://provider.indianamedicaid.com/ihcp/Bulletins/BT202022.pdf
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04/28/2021 - adding this as the expected modifier is different from what is on their website
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Carecource HIP (IN Medicaid)Telemedicine ConsultE&M Codes 99201 - 99205 and 99211-992159502Practice Location Namehttps://www.caresource.com/documents/multi-oh-telehealth-tip-sheet/
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Telemedicine Consult
92002, 92012, 92004 and 92014
N/A02Telemedicine
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Telemedicne Phone ConsultG2012 and G2010N/A02Telemedicine
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4/25/2020 - updated NC BCBS Telemedicine valid date to May 5th
4/29/2020 - updated CR modifier for phone only visit
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NC BCBS (DOS prior to 12/31/2020) Telemedicine ConsultE&M Codes 99211-99215N/A02Telemedicine Please check enc summ to see if its Phone only encounter -- where th patient could not do Video encounter -- if its mentioned that only phone call was made - then follow the coding rules for Telmedicine Phone Consulthttps://www.bluecrossnc.com/covid-19/covid-19-provider-resources
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Telemedicne Phone ConsultE&M Codes 99211-99215CR02Telemedicine
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Telemedicine ConsultNew Patient Codes 99201-99205N/A02Telemedicine New patient can only been for Covid-19 symptoms only - so the Dx can be one of these: J12.89, B97.29, J20.8, B97.29, J40, B97.29, J22, B97.29, J98.8,B97.29, J80, B97.29, Z03.818, Z20.828https://www.bluecrossnc.com/sites/default/files/document/attachment/providers/public/pdfs/news-and-information/news/2020.06.15_VirtualRounds.pdf
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Do not use the following codes99441, 99442, 99443 and 98966, 98967, 98968even Blue Mecdicare will deny these.
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TX BCBS (DOS - prior to 12/31/2020)
Telemedicine ConsultE&M Codes 99211-992159502Telemedicine not very sure of the place of service at this time.
https://www.bcbstx.com/provider/pdf/tx_using_telemed_telehealth_covid19.pdf
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Telemedicne Phone ConsultE&M Codes 99211-992159502Telemedicine
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Telemedicine ConsultNew Patient Codes 99201-992059502Telemedicine New patient can only been for Covid-19 symptoms only - so the Dx can be one of these: J12.89, B97.29, J20.8, B97.29, J40, B97.29, J22, B97.29, J98.8,B97.29, J80, B97.29, Z03.818, Z20.828
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04/12/2021 - BCBS SC coding update -- this section was not there before, we followed TX rules as they were the same for SC as well.
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SC BCBS
Telemedicine ConsultE&M Codes 99211-99215GT11Telemedicine
https://www.southcarolinablues.com/web/public/brands/sc/providers/tools-and-resources/frequently-asked-questions/virtual-care-faqs/
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Telemedicne Phone ConsultE&M Codes 99211-99215GT11Telemedicine
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Telemedicine ConsultNew Patient Codes 99201-99205GT11Telemedicine http://www.cam-policies.com/internet/cmpd/cmp/mdclplcy.nsf/DispContent/76916BD004ECAD1F852581C90051F42B?opendocument
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AL Medicaid - (DOS prior to 08/31/2020)
Provider must receive verbal consent from the recipient, and the provider must document that consent in the medical record.		Telemedicine ConsultE&M Codes 99211- 99213CR02Telemedicine hig complexity codes are not covered, the 14 office visit benefit will apply.
https://medicaid.alabama.gov/news_detail.aspx?ID=13729
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Telemedicne Phone ConsultE&M Codes 99211- 99213CR02Telemedicine
https://medicaid.alabama.gov/alert_detail.aspx?ID=14009
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TX MedicaidTelemedicine ConsultE&M Codes 99201 - 99205 and 99211-99215, 99406, 994079511Practice Location Namenot very sure of the place of service at this time.
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Telemedicne Phone ConsultE&M Codes 99201 - 99205 and 99211-99215, 99406, 994079511Practice Location Name
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SC Medicaid (through the conclusion of the State of Emergency related to COVID-19)
Can only transmit claims after 04/06/2020		Telemedicine ConsultE&M Codes 99201 - 99205 and 99211-99215GT11Practice Location Namenot very sure of the place of service at this time.
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Telemedicne Phone ConsultE&M Codes 99201 - 99205 and 99211-99215GT11Practice Location Name
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Telemedicne Phone ConsultG2012 and G2010GT11Telemedicine
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Telemedicne Phone Consult99441, 99442, 99443, 98966, 98967, 98968GT11Telemedicine
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NV MedicaidTelemedicine ConsultE&M Codes 99211-99215N/A02Practice Location Name
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Telemedicne Phone ConsultE&M Codes 99211-99215N/A02Practice Location Name
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Sunshine Health (No end date given but they may retire the telehelath program at a future date)Telemedicine ConsultE&M Codes 99201 - 99205 and 99211-99215GT11Practice Location Namenot very sure of the place of service at this time.
https://www.sunshinehealth.com/providers/coronavirus-information.html
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Telemedicne Phone ConsultE&M Codes 99201 - 99205 and 99211-99215GT11Practice Location Name
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Telemedicne Phone ConsultG2012 and G2010GT11Telemedicine
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Telemedicne Phone Consult99441, 99442, 99443, 98966, 98967, 98968GT11Telemedicine
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Medcost
(Important to check if individual plan will allow Telehealth)		Telemedicine ConsultE&M Codes 99201 - 99205 and 99211-99215N/A02Practice Location Namewill accept CR and 95 modifiers if sent, but not requiredhttps://www.medcost.com/coronavirus-covid-19#providers
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Telemedicne Phone ConsultE&M Codes 99201 - 99205 and 99211-99215N/A02Practice Location Name
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4/25/2020 - updated Tricare info in this sheet
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TricareTelemedicine ConsultE&M Codes 99201 - 99205 and 99211-99215, 99406, 99407GT02Telemedicine https://www.humanamilitary.com/provider/education-and-resources/quick-access/policy-updates-and-alerts/covid-19-telemedicine-031320
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Telemedicine Consult via Portal 99421, 99422, 99423 and G2061, G2062, G2063GQ02TelemedicineThese codes can be used only when patient used patient portal to communicate with the provider
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5/1/2020 - added
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First Choice VIP Care of SCFollow SC Medcaid Guidance until further notice
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Wellcare of South Carolina
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All SC Medicaid Plans
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02/10/2021 -- added this as per phone conversation with the Payer
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FL Healthcare Plan [FHCP]TelemedicineAll codes9502Telemedicine
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