Telemedicine Additional Information

Advanced insurance eligibility verification for patient of telemedicine Services

To verify the eligibility for a patient regarding telemedicine you should have a questioner which fulfills all the needs to get complete information on Telemedicine. Also adding the provider information in that questionnaire to see if provider can provide Telemedicine services fully or partially.

Payers which covers Telemedicine

Most of the top insurance payers like Medicare, Medicaid, BCBS, UHC, Humana, Cigna, and Aetna are covering Telehealth Medicine for now. For more clarifications we need to contact payer.

Change in Telemedicine rules on daily basis

Due to COVID-19 rules for insurances are changing on daily basis. Insurances are trying to make things workable for facilities, clinics and providers to sustain in current situation. But when all this will stop has no answer right now.


Telemedicine guidelines for each payer

Best thing we can do to get the guidelines for each payer is to call and ask for details.
We can use below mentioned few things to get the correct information.

  • Is provider contracted to perform telemedicine
  • Any specific medium need to use for telemedicine visit (Audio/Video)
  • Is there any visit limit for telemedicine visits per year?
  • Do we need to authorized telemedicine visits or not

By asking above questions from a payer you can get the information what are the guideline so far payers have for telemedicine. For few payers you have enough information now but may be for few it is not cleared yet and need to dig deep in to get more specific information because rules are changing on daily basis and it is difficult to catch up with all system at once.


Billing guidelines
  • We can use GT or 95 modifier with CPT codes (Medicare and Private Payers)
  • Place of Service (POS) should be 02 for telemedicine

If we have confusion about billing a code for telemedicine the better way is to contact the payer and ask if these codes are eligible to bill for telemedicine or not. Try to get the list of code used for telemedicine if unable to get that ask for the codes used for your provider/practice if we can bill it for POS 02 with 95 or GT modifier.