Feb 28, 2022 | Insurance
There have been mixed reports about place of service codes from insurance companies. Our Insurance Chair, Milton Marasch, has received word from Blue Cross Blue Shield Vermont in regards to how new CMS policies will affect their place of service does.
A representative from the company has indicated there will be no change in their place of service code procedures for telemedicine: The American Medical Association released a new place of service code for telemedicine – place of service 10, which is effective January 1, 2022. Our Payment Policy for Telemedicine CPP_03 will not be updated for January 1, 2022, however, until further notice, either place of service for telemedicine (02 or 10) will be accepted and processed by our system.
The CMS has a listing of the new AMA place of service (POS) codes and their descriptions - including the new POS=10 code, that should also be noted. The question was raised as to whether the POS=02 code would be used instead for the rare circumstances where the patient is a resident in a nursing facility instead of in a traditional home. The representative reported that they will accept either the place of service 10 or 02 for patients in a nursing facility that are receiving telemedicine services.
REFERENCES:
CMS link on the place of service (POS) codes: https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set
BCBSVT documentation (bottom of page 2): https://www.bluecrossvt.org/documents/january-2022-adaptive-maintenance-provider-news
New BCBSVT website link (pointing directly to providers’ section): https://www.bluecrossvt.org/providers
Feb 28, 2022 | Insurance
We encourage members to review insurance coding announcements from your various insurances on any coding changes for audio-only telehealth services. For instance, MVP has just announced Modifier V3 and Place of Service (POS) code 99 (“other”) for plain old telephone therapy, effective January 1st. We recommend taking a look directly at your insurance announcements on this topic for definitive information, or the MVP payment manual here (PDF page 21).
Feb 28, 2022 | Insurance
Our Insurance Chair, Milton Marasch, has drawn our attention to some changes to CMS place of service codes. According to at least one source, CMS looks like they will be requiring one in-person visit within 6 months of the initial tele-mental health service, and then again at least once every 12 months, with some exceptions available for the latter. APA services also reviews CMS and Medicare telehealth in 2022 here.
Feb 28, 2022 | Insurance
From Dr. Milt Marasch, VPA Insurance Chair:
Here’s an FYI for folks. I just ran across a 2016 web article from the APA on problems with coding updates for the DSM-5. Apparently some of the DSM codes did not crosswalk well to the ICD-10 codes as printed in the DSM-5 manual.
Here’s the APA article:
https://www.apaservices.org/practice/reimbursement/icd-diagnostic/code-discrepancies#:~:text=10%20for%20Social%20Anxiety%20Disorder,diagnostic%20code%20for%20different%20presentations.
<https://www.apaservices.org/practice/reimbursement/icd-diagnostic/code-discrepancies#:~:text=10%20for%20Social%20Anxiety%20Disorder,diagnostic%20code%20for%20different%20presentations.>
And here’s the direct link to the ApA (psychiatry) PDF with changes/corrections:
https://psychiatryonline.org/pb/assets/raw/dsm/pdf/DSM-5%20Coding%20Update_Final.pdf
<https://psychiatryonline.org/pb/assets/raw/dsm/pdf/DSM-5%20Coding%20Update_Final.pdf>
Feb 28, 2022 | Insurance
You may have received a 1099 for the Provider Relief Payment you received in 2020, and you may be asking whether that payment is taxable. Normally when you receive a Form 1099 for income, that income is taxable, but because VPA is not able to provide legal or tax advice, we recommend you speak to the IRS helpline, your accountant or tax expert about the issue.
You can see some additional information on here.
