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Use correct coding to ensure your telehealth claims get paid

The Center for Medicare and Medicaid Services (CMS) has issued coding changes for services provided via telehealth or audio-only, effective Jan. 1, 2022. You can avoid unnecessary claim payment denials or delays by submitting correct coding on all claims.

Magellan requires the following information on claims billed for telehealth or audio-only services:

  • Use the appropriate modifiers.
    • For telehealth services (combination of audio and live, interactive video): Include the GT or 95 telehealth modifier.
    • For audio-only services: Include the new FQ modifier. Learn more about changes effective Jan. 1, 2022.
    • Organizational providers billing professional services: Bill the license-level modifier in the first modifier field and the telehealth or audio-only modifier in the second modifier field. Example: 90791 AH, GT.
  • Include the correct telehealth place of service (POS) code:

Access helpful telehealth billing resources (and more) at MagellanProvider.com/telehealth

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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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