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Billing Q3014: Telehealth originating site facility fee

Accurate use of Q3014 is essential when providing telehealth services. Billing this code incorrectly can result in claim denials or recoupments, so it is important to understand when and how it should be used.

Flagging the problem

Our Special Investigations Unit (SIU) has identified two frequent billing issues:

• Distant site providers billing Q3014 when the member is located at home
• A single entity billing both the originating site facility fee and the professional service for the same visit

What Q3014 covers

Q3014 represents the telehealth originating site facility fee. It may be billed only by the eligible facility where the member is physically located during the telehealth visit. The distant site provider should bill only the professional service provided.

A single provider or entity may not be reimbursed as both the originating site and the distant site for the same encounter.

Example: If a provider conducts a telehealth visit with a member who is at home, the provider bills only the appropriate service code with the required telehealth modifier or place of service. Q3014 should not be billed.

Eligible originating sites

The originating site is the member’s location during the telehealth visit and must be an authorized facility, such as:

• Behavioral health clinic or practitioner office
• Hospital or critical access hospital
• Rural health clinic or federally qualified health center
• Skilled nursing facility or community mental health center

Example: If a member visits an eligible facility and connects with an outside telehealth provider who is not employed or contracted by that facility, the originating site bills Q3014 and the distant site provider bills the professional service.

Documentation requirements

When billing Q3014, the originating site must document that the member was physically present at an eligible facility and that the facility provided space, equipment, and support for the visit. Records must clearly distinguish originating site services from distant site professional services and be retained according to regulatory and contractual requirements.

Key takeaway

Q3014 reimburses eligible facilities only for hosting telehealth services. Always confirm originating site eligibility and clearly separate originating and distant site billing roles.

Verify benefits and contracted services

Coverage for Q3014 varies by member benefit plan and provider contract. You are responsible for verifying member benefits and confirming which services your facility or organization contracts with Magellan to provide. For plan or contract-specific questions, contact your network representative.

More information

• Review resources under Telehealth Billing on MagellanProvider.com.
• Review Magellan's policy on examples of fraud, waste, and abuse in Section 4 of Magellan's National Provider Network Handbook (PDF).
• If you have additional questions regarding our audit/investigation processes, contact the SIU via email at SIU@MagellanHealth.com or via our hotline 1-800-755-0850 (you can remain anonymous).