GT modifier and Teletherapy — What you need to know before October 1st

The murky world of insurance claims codes is, at best, constantly evolving; at worst, it is an amorphous time-drain on your practice as you attempt to stay up-to-date. As a full-practice management solution, the billing experts at TherapyAppointment are committed to providing time and energy-saving insights to help you navigate the claims world with ease.

The following Center for Medicare and Medicaid Services (CMS) update affects TherapyAppointment users billing and scheduling third-party video conferencing. September 6, 2018, the CMS published a revision to Place Of Service (POS) Code 02. As of October 1, 2018, the GT modifier is only required on institutional claims (see more within the link below).

So, if you are a non-institutional practice submitting Telehealth Distant Site Services claims through TherapyAppointment, this affects how you code claims submissions. Currently, you’re are allowed to include the GT modifier on the HCFA 1500 without a rejection. After October of 2018, Medicare will reject claims with GT modifiers. Be aware that this could affect your turnaround time for insurance payments and processing.

To learn more, check out the changes in their entirety on the Centers for Medicare and Medicaid Services (CMS) website or through their MLN Matters publication related to the CR here.

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This information does not constitute advice on addressing CMS Change Requests (CR) within your organization. Our goal with this publication is to highlight an industry change so that you may understand if and how you will be impacted and better manage your practice.