December 10, 2013
All Blue Cross Contracting ProvidersFrom:
Connie Winkley – Education/Communication Coordinator
Institutional Provider Relations
Blue Cross and Blue Shield of Kansas, Inc.
An Independent Licensee of the Blue Cross and Blue Shield Association
Telemedicine is the use of a telecommunications system that includes two-way voice and visual communication when used as a substitute for an in-person encounter (between provider and patient) for professional consultations, office visits, office psychiatry services, and a limited number of other physician services.
The term “originating site” means the location of patient at the time the service being furnished via a telecommunications system. Acute care hospitals to include critical access hospitals (CAH) are considered to be eligible “originating sites”. Additional originating sites include physician or practitioner offices, Rural Health Clinics, FQHCs, Skilled Nursing Facilities and Community Mental Heath Centers.
The term “distant site” means the site where the physician or practitioner, providing the professional service, is located at the time the service is provided via a telecommunications system.
Telemedicine services are billable only on outpatient claims. Originating site telemedicine services should be billed to BCBSKS on the UB04 claim form using the following guidelines:
Originating site telemedicine services will be reimbursed a maximum allowable payment (MAP) assigned to HCPCS Q3014. The allowance for Q3014 will be the same as the MAP for outpatient clinic visits, revenue code 0510.
If you have questions regarding this newsletter, please contact your Institutional Provider Representative. Denny Hartman can be reached at 1-316-269-1602, Cindy Garrison at 1-785-291-8862 and Janne Adams-Denton at 1-785-291-8813.