CMS to restructure its telehealth billing guidelines

The Centers for Medicare & Medicaid Services has introduced a new Place of Service Code that will need to be used in 2022 for telemedicine visits. Read along to get a glimpse of this new policy.
The CMS has issued a breakthrough policy update related to the billing of telemedicine services. Namely, a set of reimbursable Place of Service (POS) codes has been revised and extended. The CMS has added a new POS code 10 with the implementation date of April 4, 2022. At the same time, some other codes are to be used in a way that is significantly different from the current billing guidelines. Every healthcare provider who performs telemedicine visits is affected by this modification.
What is a Place of Service code?
Each claim form must contain all the information necessary to identify a patient’s clinical condition and the services that have been performed. In order to consider any procedure for reimbursement, insurance payers need to know at which clinical setting has a procedure been rendered. In other words, payers need to know a place of service.  For example, an outpatient physician’s office is a properly defined clinical setting and, therefore, a place of service. CMS assigns a numeric POS code to each clinical setting. Currently, there are over 50 codes used to identify various places where procedures can be rendered. Below are the two most used Place of Service codes:
• 11 – outpatient physician office• 21 – inpatient hospital• 12 – patient’s home• 02 – telehealth (unspecified).
Telemedicine services have been used & billed very frequently since the beginning of the COVID-19 pandemic. So has been a POS code 02.