Care Management Services

Technology advances and policy changes mean medical practices can now get paid for certain non-face-to-face services. But, you need to know how to code for them, consent rules, and documentation requirements, and what you’ll be reimbursed for these complex, new services.

 

Modifier 95, 93: Telemedicine

CPT® has two modifiers for telemedicine. CMS and private payers regularly change their instructions about using these modifiers and what place of service to use.  As of 2024, CMS no longer requires modifier 95 on claims but rather hopes to capture modality plus place of service by use of either POS 02 or POS 10.[1] (POS […]

Certification for Home Health Services

There are two HCPCS codes that physician, nurse practitioners, clinical nurse specialists and physician assistants can use to report developing a plan for a Medicare patient who requires home health services. The CARES Act passed in March 2020 permanently allows nurse practitioners, clinical nurse specialists and physician assistants to certify and re-certify Medicare covered home […]

Can I Get Paid for…Signing the Home Health Certification Form

An Overview of Home Health Certification CPT® CMS pays a small fee for the planning, certification, supervision and re-certification of home health services.  Don’t do the work and forget to get paid. Find out more about getting paid to sign the home health certification form in this brief video from CodingIntel dedicated to home health […]

Overview of Advance Care Planning

Advance Care Planning CPT® Codes Overview Medical practices perform countless tasks every day for which there is no payment. CMS continually states that it wants to support non-procedural and in the past decade has added payment for some non-face-to-face services, including Care Plan Oversight, Transitional Care Management and Chronic Care Management. CPT® Codes 99497 & […]

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In 1988, CodingIntel.com founder Betsy Nicoletti started a Medical Services Organization for a rural hospital, supporting physician practice. She has been a self-employed consultant since 1998. She estimates that in the last 20 years her audience members number over 28,400 at in person events and webinars. She has had 2,500 meetings with clinical providers and reviewed over 43,000 medical notes. She knows what questions need answers and developed this resource to answer those questions.

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