In the newly posted telehealth manual, Medicaid providers are required to use a new billing process for telehealth. While not an issue for ABA in Medicaid, some Therapeutic Consultation providers bill on a weekly or monthly basis rather than session by session. This would make it difficult to include the new parameters, if some services were done via telehealth and others not.
We have contacted DMAS and they have told us “Until DMAS issues additional guidance regarding telehealth and requirements, please continue to bill as usual. “
Therefore, please continue to bill as you have been until more information comes forward.
Here is what the manual says:
“ Reimbursement and Billing for Telehealth Services
Telehealth Place of Service (POS)
Providers must use the place of service code that reflects the originating site:
• POS 02 – used for telehealth services when the originating site is other than the
member’s home
• POS 10 – used for telehealth services when the originating site is the member’s
home
Telemedicine and audio-only telehealth
Distant site Providers must include:
• the modifier GT on claims for services delivered via telemedicine
• the modifier 93 on claims for services delivered via audio-only telehealth.
CPT codes for activities that are not considered to be essentially in-person services per
the CPT Manual do not require telehealth modifiers. Examples include codes used
exclusively for audio-only delivery of services (see Table 7 in this supplement below).
Refer to the CPT Manual for additional guidance.
Store-and-Forward
Distant site Providers must include the modifier GQ.”