CTC CTC Reimbursement & Billing for Telehealth 1 — Questions and Answers
Question 1: Which federal program first established telehealth reimbursement policies for rural areas under the Balanced Budget Act of 1997?
- Medicaid
- Medicare (Correct answer)
- CHIP
- TRICARE
Correct answer: Medicare
Medicare was the first federal program to establish formal telehealth reimbursement under the Balanced Budget Act of 1997, initially limited to rural originating sites.
Question 2: What is the correct place of service (POS) code used when billing Medicare for a telehealth visit conducted via real-time audio-visual technology?
- POS 02 (Correct answer)
- POS 11
- POS 22
- POS 99
Correct answer: POS 02
POS 02 (Telehealth) is the designated place of service code for Medicare telehealth visits conducted via real-time interactive audio-visual technology.
Question 3: Which modifier is appended to CPT codes to indicate a service was provided via telehealth for Medicare billing?
- -GT (Correct answer)
- -GQ
- -95
- -FQ
Correct answer: -GT
The -GT modifier (via interactive audio and video telecommunications systems) is used with CPT codes to indicate Medicare telehealth services.
Question 4: Under the COVID-19 public health emergency waivers, which originating site restriction was temporarily lifted for Medicare telehealth?
- The patient's home became an eligible originating site (Correct answer)
- Only hospitals could serve as originating sites
- Rural health clinics were excluded
- Mental health services were restricted
Correct answer: The patient's home became an eligible originating site
During the COVID-19 PHE, CMS waived the rural originating site requirement, allowing patients' homes to serve as eligible originating sites for Medicare telehealth.
Question 5: What is a 'distant site' in telehealth billing terminology?
- The location where the patient receives the telehealth service
- The location where the healthcare provider is located during the telehealth visit (Correct answer)
- The data center hosting the telehealth platform
- The insurance company processing the claim
Correct answer: The location where the healthcare provider is located during the telehealth visit
The distant site is the location of the healthcare provider rendering the telehealth service, as opposed to the originating site where the patient is located.
Question 6: Which of the following telehealth service types is typically NOT eligible for Medicare reimbursement?
- Synchronous audio-visual visits
- Store-and-forward transmission only (without real-time interaction) (Correct answer)
- Remote patient monitoring
- Behavioral health integration services
Correct answer: Store-and-forward transmission only (without real-time interaction)
Medicare generally does not reimburse store-and-forward (asynchronous) telehealth, except in approved federal telemedicine demonstration programs in Alaska and Hawaii.
CTC CTC Reimbursement & Billing for Telehealth 1
Which federal program first established telehealth reimbursement policies for rural areas under the Balanced Budget Act of 1997?