Fusion and thera-LINK are both companies under Therapy Brands, our parent company. This means we were able to access their resources and start an integration a lot faster than if we had partnered with another company.
What payers reimburse for teletherapy?
Unfortunately, payer reimbursement varies greatly across states and services. So even though a payer may reimburse for services in one state, it doesn’t mean that the same payer will reimburse in another state. You’ll want to check with your state’s regulations and then verify with your payers that your services will be reimbursed. Check out our Resources for Teletherapy page for more information. Policies have been developing and changing almost daily due to COVID-19. The Center for Connected Health Policy is striving to provide up-to-date information about these developments and changes. We encourage you to check out their resources as well, including their fact sheets.
What billing codes can I use with teletherapy?
The billing codes that are reimbursable through teletherapy can vary across payers, so you’ll want to check with your payers about what billing codes are reimbursable and if any modifiers need to be used. Check out our Resources for Teletherapy page for more information.
What modifier do I use?
Submit claims for telehealth services using the appropriate CPT or HCPCS code for the professional service along with the telehealth modifier identified by the payer. Common modifiers are 95 or GT, “via interactive audio and video telecommunications systems” (for example,97530 GT/95). However, some payers are also using GQ and/or CR. Most payers are using the 95 modifier code but you should always confirm with the payer!
Where do modifiers go on the claim form and how do I add them?
On the HCFA 1500 claim form, modifiers can be entered in item 24D. They can be manually added, or you can reach out to our support team to see if they can set-up a claim rule so that they are automatically added. You can reach our support team by emailing firstname.lastname@example.org
How do I change the place of service code on a claim?
The place of service code appears in item 24B on the claim form. The place of service code can be manually changed from the claim form, or you can create a new location for teletherapy so that the place of service code automatically populates on claims.