New Telehealth Place of Service Code

The new Physician and Non-Physician Fee Schedule, effective March 1, 2017, adds many reimbursable telemedicine codes. It also adds a new Place of Service Code – 02. Remember, all treatment, including telemedicine, requires prior authorization from the claims administrator.

Frequently Asked Question

Q: What sort of impact could telemedicine have on workers’ comp?

A: Telemedicine presents an intriguing possible source of revenue for California workers’ comp providers. To start with, any practice offering telemedicine services places itself at a competitive advantage – as the boundary between healthcare and technology continues to blur, it pays to keep up with the times. Telemedicine can also increase a provider’s reach, enabling them to treat patients across the state (perhaps even at home or after hours). Finally, telemedicine could reduce no-shows and missed appointments, thereby recouping revenue that might otherwise be lost.

Remember, all treatment, including telemedicine, requires prior authorization from the claims administrator.

Explanation

The term “telemedicine” refers to the emerging collection of healthcare and health education services available through telecommunication technology. It’s a rapidly-growing field, with new ideas and procedures developed on an almost-daily basis. This kind of growth caught the eye of  the Centers for Medicare and Medicaid Services (CMS), prompting them to add the new place of service code 02 to the physician fee schedule for telemedicine. Providers billing for telemedicine services will use the Facility payment rate. This rate, calculated as part of the Practice Expense RVU (RVUPE), is generally lower than the non-facility rate, as it does not include overhead expenses.

Additional Information

DWC Official Medical Fee Schedule

Medicare RVU17A

DaisyBill Resources

Blog Post: New Fee Schedule Adds Place of Service Code for Telehealth

Webinar: 2017 Work Comp Changes

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