New Fee Schedule Adds Place of Service Code for Telemedicine

New Fee Schedule Adds Place of Service Code for Telemedicine

This 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 telemedicine.

The term “telemedicine” refers 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.



Reimbursement Effective 3/1/2017


Office/outpatient visit est



Esrd home pt serv p day <2



Esrd home pt srv p day 2-11



Esrd home pt srv p day 12-19



Esrd home pt serv p day 20+



Advncd care plan 30 min



Advncd care plan addl 30 min



Crit care telehea consult 60



Crit care telehea consult 50


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 webinar.


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