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December 2016

Online visits and telemedicine claims reporting clarified

On July 1, 2016, Blue Cross began extending services under telemedicine to include all codes specific to range of practice.

Submitted codes must have a GT modifier added. Modifier GT defines services given through interactive audio and video telecommunication systems.

However, certain codes don’t need the GT modifier. For example, online (98969 and 99444) and telephone (99443, 98966, 98967 and 98968) evaluation and management visits don’t need the GT modifier.

How to report in an office location

When the patient is initiating an online (98969 and 99444) or telephone (99443, 98966, 98967 and 98968) E&M service, providers should report an office location of service code (11-office) with the applicable online visit or telephone E&M procedure code. When a telemedicine E&M visit is submitted with a GT modifier, (e.g., 99212 – GT) also report the office location of service code.

How to report in a facility setting

If the patient is located in a facility setting, the applicable location of service code should be reported for telemedicine services. Refer to the Blue Cross telemedicine medical policy for more details.

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*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2015 American Medical Association. All rights reserved.
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