Telehealth/telemedicine - new modifiers for audio-only services and information on place of service 10 when billing for COVID-19 related services

Washington State Health Care Authority sent this bulletin at 02/08/2022 09:43 AM PST

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Apple Health (Medicaid) Provider Alert

Attention providers

What changed?

New modifiers for audio-only services
Per federal guidelines, there are new modifiers for audio-only services. See the appropriate sections within the online resources listed below for details and effective dates.

This provider alert revises the instructions under “New modifier for audio-only” for the provider alert sent on December 17, 2021.

New place of service (POS) code 10 and revised definition of POS 2
Effective for claims with dates of service on and after April 4, 2022, HCA will implement the following new place of service (POS) code 10 and the revised definition of POS 02 when billing the HIPAA-compliant telemedicine (audio-visual) or telehealth (audio-only).

Note: Providers whose billing systems are ready to bill using the new POS 10 prior to April 4, 2022, may begin to do so effective for claims with dates of service on and after January 1, 2022.

Online resources

HCA has published updates to the following online resources, which are now located on HCA’s Provider billing guides and fee schedules webpage, Billing guides and fee schedules, under Telehealth:

Applied behavior analysis (ABA): Apple Health (Medicaid) Applied Behavior Analysis (ABA) policy and billing during the COVID-19 pandemic
Behavioral health policy and billing: The Apple Health (Medicaid) behavioral health policy and billing during the COVID-19 pandemic (FAQ) has been updated to reflect changes in telehealth. Please refer to the appropriate section of the FAQ for details. The Service Encounter Reporting Instructions (SERI) Guide is in section I, the fee-for-service Mental Health Billing Guide (part 2) is in section II, and the fee-for-service Mental Health Billing Guide (part 1) is in section III.
Clinical policy and billing: Apple Health (Medicaid) clinical policy and billing for COVID-19 (includes telemedicine/telehealth)
Diabetes education: Apple Health (Medicaid) frequently asked questions (FAQ) for diabetes education providers in the COVID-19 pandemic
Family planning only: Family Planning Only (FPO) Program billing guide for telemedicine/telehealth services offered during the COVID-19 pandemic
Physical therapy/Occupational therapy/Speech therapy: Apple Health (Medicaid) telehealth requirements for physical, occupational, and speech therapy during COVID-19 pandemic

About the Health Care Authority (HCA)

The Washington State Health Care Authority (HCA) is committed to whole-person care, integrating physical health and behavioral health services for better results and healthier residents.

HCA purchases health care for more than 2.5 million Washington residents through Apple Health (Medicaid), the Public Employees Benefits Board (PEBB) Program, the School Employees Benefits Board (SEBB) Program, and the COFA Islander Health Care Program. As the largest health care purchaser in the state, we lead the effort to transform health care, helping ensure Washington residents have access to better health and better care at a lower cost.

Please do not reply directly to this message. For more information, visit the HCA website, where you'll also find contact information.

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Nondiscrimination

The Washington State Health Care Authority (HCA) complies with all applicable federal and Washington state civil rights laws and is committed to providing equal access to our services. Visit HCA’s website to view complete nondiscrimination statements.

Telehealth/telemedicine - new modifiers for audio-only services and information on place of service 10 when billing for COVID-19 related services

Apple Health (Medicaid) Provider Alert

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About the Health Care Authority (HCA)

Disclosure notice

Nondiscrimination