Telehealth Place of Service Codes Updated: Additional Billing Information
Wednesday, June 8, 2022
Please note: This is a clarification of our May 2022 correspondence titled, “Telehealth Place of Service Codes Updated.” We apologize for any confusion that resulted from the missing billing information detailed below, which was not included in the prior communication about telehealth place of service code (POS) 10 (Telehealth Provided in Patient’s Home).
On May 26, 2022, TRICARE adopted a recent change to telehealth POS codes, which went into effect for Centers for Medicare & Medicaid Services (CMS) on April 1, 2022, concerning dates of service on or after Jan. 1, 2022. This change included the addition of POS 10 to the telehealth category to offer providers greater specificity when billing for telehealth encounters.
Currently, providers can only bill POS 10 when using CMS 1500 Health Insurance Claim Form via hard copy or electronic data interchange (EDI).
POS 10 will not be available for use with XPressClaim until late July. If you are a provider using XPressClaim, you should use POS 02 until POS 10 is available for use with XPressClaim.
For more information on CMS POS codes, visit CMS.gov.
Place of service telehealth codes
- POS 02 – Telehealth Provided Other than in Patient’s Home: Health care services delivered through video conferencing technology in a setting outside of the beneficiary’s home (for use with CMS 1500 Health Insurance Claim Form via hard copy, EDI or XPressClaim)
- POS 10 – Telehealth Provided in Patient’s Home: Health care services delivered through video conferencing technology in the beneficiary’s home (for use with CMS 1500 Health Insurance Claim Form via hard copy or EDI only; do not use with XPressClaim until late July)
Telehealth and TRICARE
The use of secure video conferencing to deliver medically and psychologically necessary services to beneficiaries is covered by TRICARE. Providers should use one of the appropriate telehealth modifiers (95, GT or GQ) when billing POS 10. For more information on coverage and requirements, refer to TRICARE Policy Manual, Chapter 7, Section 22.1, or refer to our Telemedicine Services page.