CMS: Use modifier -CS with additional telehealth services
Six codes for telehealth services are newly eligible to reported with modifier -CS (cost-sharing), which requires Medicare to cover beneficiary cost-sharing during office visits and other encounters for the duration of the public health emergency.
The update adds the following HCPCS Level II codes to the list, effective for Medicare claims with dates of service on or after January 1, Revenue Cycle Advisor reported:
- G2250, remote assessment of recorded video and/or images submitted by an established patient, including interpretation with follow-up with the patient within 24 business hours, not originating from a related service provided within the previous seven days nor leading to a service or procedure within the next 24 hours or soonest available appointment
- G2251, brief communication technology-based service by a qualified healthcare professional who cannot report E/M services, provided to an established patient, not originating from a related service provided within the previous seven days nor leading to a service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of clinical discussion
- G2252, …; 11-20 minutes of medical discussion
In addition, CMS will also allow modifier -CS to be appended to the following CPT codes for online assessment services:
- 98970, qualified nonphysician healthcare professional online digital assessment and management, for an established patient, for up to 7 days, cumulative time during the 7 days; 5-10 minutes
- 98971, ...; 11-20 minutes
- 98972, …; 21 or more minutes
Modifier -CS may be reported with range of office and other outpatient services; hospital observation services, emergency department services, online digital E/M services, and others. Additional information on modifier -CS is available here.
Revenue integrity professionals should ensure that systems are updated and affected claims reviewed to prevent inappropriate collection of copayments or coinsurance.