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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

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.