How to report telemedicine services in an outpatient psychiatric care facility

If you’re providing telemedicine services from an outpatient psychiatric care facility, follow these guidelines to ensure your claims process correctly.

Electronic claims
Here’s the instructions for electronic claims:

• Report the individual National Provider Identification number of the provider who performed the service in Loop 2010AA NM109.
• Report place of service code 02 in Loop 2300 CLM05.
• Report modifier GT or 95 in Loop 2400 SV101-3.

Review our Blue Cross Blue Shield of Michigan provider manuals for 1500 claim form instructions. As a reminder, only providers with individual NPIs can bill for telemedicine services.

Call the EDI help desk at 1-800-542-0945 if you have questions about electronic claim submissions.

Paper claims

For paper claims, you must report telemedicine services with a place of service code 02 and the modifier GT or 95. If you’re a provider rendering telemedicine services from an outpatient psychiatric care facility, you must report your individual provider identification number.

All outpatient psychiatric care facilities reporting a provider identification numbers beginning with 091 must be reported with a place of service code 52 or 53. To avoid your claim from rejecting for invalid place of service, remember to bill with the appropriate place of service.

For billing questions, contact your provider consultant.