COVID-19 is not quite over and providers may still utilize telehealth as a safer alternative to in-person treatment. However, the billing aspect can present a few complications. Chiropractors are often confused if they can indeed perform and be paid for telehealth.

For guidance look no further than to United Health Care and Optum Health which have adopted specific guidelines and protocols for chiropractic providers. These are similar to those adopted by Medicare and though Medicare does not cover chiropractic for services other plans that utilize Medicare guides would or may allow reimbursement. For example, this includes California workers’ compensation.

These services may include more than a conference or consultation where an E&M code would be appropriate but include some physical medicine services.

It is important to consider telehealth is not a type of medical treatment; telehealth is a means of delivering medical treatment.

The list published for telehealth services is as follows

99202 Office/outpatient visit new patient

99203 Office/outpatient visit new patient

99204 Office/outpatient visit new patient

99205 Office/outpatient visit new patient

99212 Office/outpatient visit established patient

99213 Office/outpatient visit established patient

99214 Office/outpatient visit established patient

99215 Office/outpatient visit established patient

97110 Therapeutic exercises

97112 Neuromuscular reeducation

97116 Gait training therapy

97530 Therapeutic activities, one-to-one patient contact, each 15 minutes

97535 Self-care management training

97750 Physical performance test

97755 Assistive technology assessment

97760 Orthotic management and training 1st encounter

You will note listed here are some one-on-one therapeutic procedures. While these require direct attendance they do not require that the provider “contact the patient physically” but be present to instruct, guide, and assure proper protocols are followed.

This option may facilitate when an in-person visit cannot be completed, and to assure continuity of care and patient progress.

For telehealth claims, the Place of Service (POS) that is reported on the bill reflects the place of service where the treatment would normally take place (meaning you still use place of service 11).  However, the service is appended with modifier 95 to designate as telehealth.


Leave a Reply

Avatar placeholder