How To Bill


How to Bill for Telemedicine

The service will need to have a GT modifier to indicate the delivery method was telemedicine. This modifier alone will not allow the facility to bill for telemedicine. In order to receive reimbursement for telemedicine services, a Q3014 must also be submitted.

Examples of how to Bill for Telemedicine

Example 1

Provider X in eastern Kansas has a member he is seeing via telemedicine in western Kansas. The Provider X employee is located in their main office in Kansas City and the member is located in a Liberal SRS office with a space rented out by Provider X. Provider X pays for the teleconferencing equipment for both locations. The member receives 30 minutes of individual counseling delivered via telemedicine. The claim would look like this:

Correct Billing

Service Date Units Service Code Modifier Allowed Amount
1/1/2009 2 H0004 GT Regular claim amount for this service
1/1/2009 2 Q3014   2 x the rate for this code because there are 2 units

The provider would have to bill both the GT modifier and the Q3014 in order to receive the extra dollars associated with telemedicine.

Incorrect Billing

Service Date Units Service Code Modifier Allowed Amount
1/1/2009 2 H0004 GT Regular claim amount for this service

The provider did not include the Q3014 facility code along with the GT modifier. Therefore, the provider will not be compensated (i.e. receive a denial) for delivering this services via telemedicine.

Example 2

Provider X in eastern Kansas has a member she is seeing via telemedicine in western Kansas. The Provider X employee is located in their main office in Kansas City and the member is located in a Liberal SRS office with a space rented out by Provider X. Provider X rents the teleconferencing equipment. The member receives 30 minutes of group counseling delivered via telemedicine. After group ends, the member receives an additional 15 minutes of individual counseling. Later in the day, the same member takes part in a peer-mentoring group for 30 minutes with a peer mentor in Liberal. The claim would look like this:

Correct Billing

Service Date Units Service Code Modifier Allowed Amount
1/1/2009 2 H0005 GT Regular claim amount for this service
1/1/2009 2 H0038 HQ Regular claim amount for this service
1/1/2009 1 H0004 GT Regular claim amount for this service
1/1/2009 3 Q3014   3x the rate for this code

The provider did not deliver the peer support via telemedicine but did deliver the individual and group counseling services via telemedicine.

Incorrect Billing

Service Date Units Service Code Modifier Allowed Amount
1/1/2009 2 H0005 GT Regular claim amount for this service
1/1/2009 2 H0038 HQ Regular claim amount for this service
1/1/2009 1 H0004 GT Regular claim amount for this service
1/1/2009 1 Q3014   3x the rate for this code

The provider delivered 2 units of group and 1 unit of individual counseling but only put 1 unit under the facility code.

Incorrect Billing

Service Date Units Service Code Modifier Allowed Amount
1/1/2009 2 H0005 GT Regular claim amount for this service
1/1/2009 2 H0038 HQ   GT Regular claim amount for this service
1/1/2009 1 H0004 GT Regular claim amount for this service
1/1/2009 3 Q3014   3x the rate for this code

In the example above, the peer support group was not delivered via telemedicine. The certified peer mentor was in Liberal along with the group of members.