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Billing mental health telehealth to Health Partners

Dao Xiong 2 weeks ago in Telehealth updated by Vicki/Billing 2 weeks ago 6

Have anyone billed Mental Health Telemedicine claims to Health Partners?  Do you bill with modifier and if so what modifier code is billed with cpt code?

Yes, we are billing HP with modifier GT and place of service needs to be "02" for telehealth".   Some insurance (Cigna, Preferred One) are using modifier 95, with place of service still "02".  

We are not billing a modifier, but are using the 2 POS. 

I don't know if that is just contractual for us, but when I called, they sent me information from the manual that has in it: "Coverage of Telehealth/Telemedicine services for certain products may not be available. Providers should verify coverage by calling the HealthPartners Member Services department." But, if you call them, they direct you to your contract person - and that is the person who sent me the information from the manual. I guess we're just throwing it up against the wall to see what will stick. 

The information from the manual does say no modifier is required. We have billed one to HP so far, but no reimbursement, yet. No denial, so that's encouraging.

Sarah,

We too are billing HEP POS 02 with no modifier. We've not seen any denials, yet. We are hopeful. 

It is my understanding that HP has 3 categories of contracts/policies: PMAP, Medicare Advantate and "commercial." Medicare It is also my understanding the most Medicare Advantage  plans do not cover telehealth when the patient/client is in the home (and are not covered by the legislation passed last week for Medicare, which is not Medicare Advantage). You can either submit a clam with the info provided above (although it is not consistent, this may be because the info is for different contracts) or you could call to check on how to bill for a specific patient. Sorting out billing questions is probably the biggest hassle for starting a telehealth service. 

We're using the GT modifier with POS: Telehealth.

I'm sorry if this has been asked but How does Medicare and Medicaid (wisconsin) want services to be billed for telehealth?.  Does anyone understand.  Thanks you