Steps you must take to get max Medicare reimbursement for phone visits

Make sure to code appropriately to get your full reimbursement.

As reported last week, retroactive to March 1, CMS will pay for phone visits the same as in-person appointments. Note that CMS won’t automatically reimburse claims submitted April 30 and later at the in-person rate unless you code as follows:

  • 1) Report 99441-99443 with modifier 95.
  • 2) Report the place of service (POS) the visit would have taken place in person (e.g., 11-Office, 22-Hospital Outpatient, 23-ASC).
  • 3) Do not use POS 02.

There is no word yet on when Medicare Administrative Contractors (MACs) will automatically reprocess claims submitted between March 1 to April 30 at the new rates. More information on telephone and telehealth coding is available in the [updated May 8] tri-society coding guide.

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