Kansas reimbursement for telemedicine PDF Print E-mail

KANSAS MEDICAL ASSISTANCE PROGRAM
PROVIDER MANUAL (See page 2-31)

Kansas reimburses for telepsychiatry + a separate facility fee (Q3014) 

TELEMEDICINE Updated 08/10

Telemedicine is the use of communication equipment to link health care practitioners and patients in

different locations. This technology is used by health care providers for many reasons, including

increased cost efficiency, reduced transportation expenses, improved patient access to specialists and

mental health providers, improved quality of care, and better communication among providers.

Office visits, individual psychotherapy, and pharmacological management services may be reimbursed

when provided via telecommunication technology. The consulting or expert provider must bill the codes

listed below using the GT modifier and will be reimbursed at the same rate as face-to-face services. The

originating site, with the beneficiary present, may bill code Q3014.

The KHPA Medical Plans no longer recognizes AMA CPT® consultation codes (ranges 99241 – 99245

and 99251 – 99255) for payment. Any service previously billed with a consultation code should be billed

with an available code that most appropriately describes the level of service provided.

If the primary payer for the service continues to recognize consultation codes, physicians and others

billing for these services may proceed in either one of the following ways:

 Bill the primary payer a CPT® evaluation and management (E&M) code that is appropriate for

the service, and then report the amount actually paid by the primary payer along with the same

E&M code to Medicaid for determination of whether payment is due.

 Bill the primary payer using a consultation code that is appropriate for the service, and then report

the amount actually paid by the primary along with an E&M code that is appropriate for the

service to Medicaid for determination of whether payment is due.

90801GT 90804GT - 90809 90847GT

90862 99201GT - 99205GT 99211GT - 99215GT

99261GT - 99263GT 99271GT - 99275GT H0001GT

H0004GT H0005GT H0006GT

H0007GT H0038GT H0038HQGT

LIMITATIONS

 The patient (beneficiary) must be present at the originating site.

 Email, telephone and facsimile transmissions are not covered as telemedicine services.

 Documentation requirements are the same as face-to-face services, see Section 2710.

 

For more information see the ATA Wiki page for Kansas here.

Last Updated on Wednesday, 22 June 2016 12:00