Billaroo badge

Blog: Daisy News

News, data, & insights about workers' comp billing

Header illustration blog

New Fee Schedule Adds Place of Service Code for Telemedicine

February 9, 2017 by Catherine Montgomery

telehealth telemedicine physician fee scheduleThis week, we provided an overview of the upcoming changes to the Physician and Non-Physician section of the Official Medical Fee Schedule (OMFS). Today, we turn our attention to another intriguing update included in the forthcoming Physician and Non-Physician Fee Schedule: The new Place of Service Code for telehealth.

The terms “telehealth” or "telemedicine" refer to the emerging collection of healthcare and health education services available through telecommunication technology. It’s a rapidly-growing field, with new ideas and procedures developed on an almost-daily basis. This kind of growth caught the eye of  the Centers for Medicare and Medicaid Services (CMS), prompting them to add the new place of service code 02 to the physician fee schedule for telemedicine. Providers billing for telemedicine services will use the Facility payment rate. This rate, calculated as part of the Practice Expense RVU (RVUPE), is generally lower than the non-facility rate, as it does not include overhead expenses.

The new Physician and Non-Physician Fee Schedule, effective March 1, 2017, adds many reimbursable telemedicine codes. Below are a few examples. Remember, all treatment, including telemedicine, requires prior authorization from the claims administrator.

Code

Description

Reimbursement Effective 3/1/2017

99214

Office/outpatient visit est

$99.54

90967

Esrd home pt serv p day <2

$24.14

90968

Esrd home pt srv p day 2-11

$20.78

90969

Esrd home pt srv p day 12-19

$20.31

90970

Esrd home pt serv p day 20+

$10.44

99497

Advncd care plan 30 min

$102.57

99498

Advncd care plan addl 30 min

$95.94

G0508

Crit care telehea consult 60

$263.68

G0509

Crit care telehea consult 50

$254.27

We've reached out to the DWC for more information about telehealth services and reimbursements. We will update this blog with more information as it is made available.

Telemedicine presents an intriguing possible source of revenue for California workers’ comp providers. To start with, any practice offering telemedicine services places itself at a competitive advantage – as the boundary between healthcare and technology continues to blur, it pays to keep up with the times. Telemedicine can also increase a provider’s reach, enabling them to treat patients across the state (perhaps even at home or after hours). Finally, telemedicine could reduce no-shows and missed appointments, thereby recouping revenue that might otherwise be lost.

There’s sure to be plenty more news on this subject as the field continues to grow – stay tuned for more updates as they come in.


For a closer look at the new telemedicine Place of Service Code, as well as an overview of all the fee schedule and legislative changes affecting workers’ comp billing in 2017, sign up for our upcoming webinars.

Sign Me Up for Feb 21 Sign Me Up for Feb 28

About Us Logo small inverted

DaisyBill is a trusted authority on workers’ comp billing. Thousands of work comp professionals attend our webinars and state agencies and professional organizations turn to us for our expertise. We created this blog to help everyone involved in workers’ compensation; sharing news, tips, and data of interest to the community.

Drop us a line with any news you would like us to share or any issue that concerns you.