With the growing popularity of telehealth services, the Centers for Medicare and Medicaid Services (CMS) have introduced new guidelines for healthcare providers to code and bill for communication technology-based services (CTBS) for Medicare beneficiaries.
These services, which involve the use of virtual communication tools such as telephone, email, or secure messaging to provide healthcare services, have become increasingly important in the wake of the COVID-19 pandemic.
In order to receive reimbursement for CTBS, providers must follow specific coding and billing rules. Here are some key things to keep in mind:
Understanding CTBS Codes
The CMS has introduced three new HCPCS codes for CTBS. These codes include:
G2012: Brief communication technology-based service, e.g. virtual check-in
G2010: Remote evaluation of recorded video and/or images submitted by an established patient, including interpretation and report, furnished to the patient/caregiver
G0071: Virtual check-in services furnished to beneficiaries in rural areas
These codes are intended to capture different types of CTBS, from brief check-ins to more comprehensive virtual evaluations. It’s important for providers to choose the appropriate code based on the services they provide to ensure accurate billing.
Billing for CTBS
In order to bill for CTBS, providers must meet specific criteria. These criteria include:
The service must be provided to an established patient
The patient must initiate the communication
The communication must be conducted using a HIPAA-compliant platform
The communication must be medically necessary and relate to the patient’s current medical condition
The service must be initiated by the provider, who can bill for the service
The provider must document the service in the patient’s medical record
The provider must also meet the minimum required time for the service, which is defined as follows:
G2012: Brief communication technology-based service, e.g. virtual check-in: minimum of 5 minutes of medical discussion
G2010: Remote evaluation of recorded video and/or images submitted by an established patient, including interpretation and report, furnished to the patient/caregiver: minimum of 16 minutes of time spent on the service
G0071: Virtual check-in services furnished to beneficiaries in rural areas: minimum of 5 minutes of medical discussion
When billing for CTBS, providers should use the appropriate HCPCS code for the service provided and report the service on the same day it was provided.
Potential Reimbursement
Reimbursement rates for CTBS can vary based on geographic location and other factors. The reimbursement rate for G2012 and G0071 is approximately $15, while the reimbursement rate for G2010 is approximately $40. These rates are subject to change, so it’s important for providers to stay up-to-date on the latest reimbursement rates in their area.
Benefits of CTBS
There are many benefits to using CTBS, both for providers and patients. CTBS can help providers save time by allowing them to communicate with patients virtually, which can also improve patient access to care. Patients who use CTBS can save time and money by avoiding unnecessary office visits and can receive care in the comfort of their own homes. Additionally, CTBS can improve patient engagement and satisfaction by allowing patients to communicate with their providers more easily.