What is Telemedicine?

Telemedicine is the delivery of health care services by means of information and communication technologies which facilitate the assessment, diagnosis, consultation, treatment, education, care management, and self-management of a patient's health care while such patient is at the originating site and the health care provider is at the distant site. Telehealth or telemedicine shall also include the use of asynchronous store-and-forward technology.

Does MO HealthNet reimburse for Telemedicine services?

MO HealthNet reimburses for services provided via telemedicine when the service can be performed with the same standard of care as a face to face service.

How do I bill for Telemedicine?

  • Most claims for services provided at the Distant Site (where the health care provider is located) are to billed with the appropriate Current Procedural Terminology (CPT) code for the service along with place of service 02. Exceptions to this include:
    • Claims for Distant Site services provided on school grounds should be billed with the appropriate CPT code for the service along with place of service 03 and a GT modifier.
    • Providers delivering behavioral health services via telemedicine, for participants located in a residential or inpatient place of service (Place of service codes 14, 21, 33, 51, 55, 56 or 61), must bill with the GT modifier and with the place of service where the participant is physically located.
  • Claims for the Originating Site (where the patient is located) are billed with procedure code Q3014.
    • Q3014 cannot be billed when participant is receiving services at home

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