CTP - Certified Telehealth Practitioner Documentation and Billing Questions and Answers

Question 1

A provider in their office conducts a synchronous video telehealth visit with an established patient who is located in their home. To ensure proper billing to Medicare, which Place of Service (POS) code should be used on the claim form?

Accepted Answer

POS 10 (Telehealth Provided in Patient’s Home)

Answer

According to CMS guidelines, the Place of Service (POS) code for a telehealth visit should reflect the location of the patient at the time of the service. POS 10 is specifically designated for telehealth services provided when the patient is in their home. POS 02 is used when the patient is at an originating site that is not their home, and POS 11 (Office) and POS 12 (Home) are for in-person encounters.

Question 2

Which of the following is a critical documentation element uniquely required for a telehealth encounter that is not typically necessary for an in-person visit?

Accepted Answer

Documentation of the patient's and provider's physical locations.

Answer

While all other options are standard components of medical documentation, the physical locations of both the patient and the provider must be documented for a telehealth visit. This is essential for verifying licensure compliance, adhering to payer-specific billing regulations, and determining legal jurisdiction.

Question 3

A practitioner is billing for a 45-minute psychotherapy session delivered via a real-time, interactive audio and video platform. Which CPT modifier should be appended to the service code to indicate the method of delivery?

Accepted Answer

Modifier 95

Answer

Modifier 95 is the standard CPT modifier used to indicate that a service was a 'Synchronous Telemedicine Service Rendered Via a Real-Time Interactive Audio and Video Telecommunications System.' While the GT modifier was used historically for this purpose, Modifier 95 is the current standard for most payers, including Medicare, for these types of services. Modifier 93 is for audio-only services, and Modifier 25 is for a significant, separately identifiable E/M service.

Question 4

What is the primary purpose of the HCPCS code Q3014 in telehealth billing?

Accepted Answer

To bill an originating site facility fee for hosting a patient.

Answer

HCPCS code Q3014 is used by an eligible originating site (the location where the patient is located) to bill a facility fee. This fee reimburses the originating site for the costs of hosting the patient and facilitating the telehealth connection with the distant site provider. It cannot be billed if the patient is at home.

Question 5

When documenting a patient's informed consent for a telehealth visit, which of the following elements is MOST critical to include?

Accepted Answer

A confirmation that the patient understands the potential risks, benefits, and limitations of receiving care via telehealth.

Answer

A core component of informed consent for telehealth is ensuring the patient understands that this modality is different from in-person care. This includes discussing and documenting their understanding of potential limitations (e.g., a physical exam cannot be fully performed), privacy and security risks, and the possibility of technology failures.

(CTP) Certified Telehealth Practitioner Practice Test

(CTP) Certified Telehealth Practitioner Practice Test

CTP - Certified Telehealth Practitioner Documentation and Billing Questions and Answers