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Take a close-up look at telehealth and audio-only billing changes effective Jan. 1, 2022

Revised definition of place of service (POS) code 02 and new POS code 10

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The Centers for Medicare & Medicaid Services (CMS) has issued changes to POS codes for use when reporting telehealth services*:
  • POS code 02 description changed to “telehealth provided other than in patient’s home.”
  • POS code 10 added with description “telehealth provided in patient’s home.”
Magellan providers who bill telehealth or audio-only services on an 837p transaction or CMS 1500 form must submit the appropriate telehealth POS code:
  • If the member is at a location other than their home, bill POS 02.
  • If the member is in their home, bill POS 10.

New modifier for reporting audio-only services -- FQ modifier

CMS allows some services to be furnished as audio-only when the member does not have access to two-way audio-visual communication technology or did not consent to its use. To review services permitted by CMS to be furnished as audio-only, see Magellan’s telehealth billing instructions at www.MagellanProvider.com/telehealth.  

To report audio-only services (this would include services conducted via telephone or secure video teleconferencing platform with video turned off), Magellan providers should bill the FQ audio-only modifier.

Make sure you’re using correct coding for all telehealth services—learn more in our related article.

 

*Guidance in this article may not apply to all plans (e.g., Pennsylvania HealthChoices). Refer to your contract and state-/plan-specific webpages.

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About Provider Focus

Welcome to Provider Focus, our award-winning e-newsletter for network providers! Here you’ll find articles and information to keep you up-to-date on news and topics relevant to serving Magellan members, including a section for regional- and plan-specific news. Check back as a new issue is released each quarter.

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