Adding Modifier's to Billing Codes and more- (TeleHealth)

  • restrict billing code by credentials

  • add multiple rates per billing code

  • add modifier’s to billing codes

  • add multiple modifiers to billing codes

escription:

How To:

Good To Know:

escription:

How To:

Good To Know:

GO TO Funders > Billing Codes:

 

  • if you are being authorized for a billing code but have the option to use 1 or more modifiers within that authorized code, follow the steps below

  • if you are being authorized SEPARATELY per modifier, you will want to enter these as SEPARATE billing codes altogether

OPEN applicable billing code:

 

  • if a client has already been authorized for a service and provider can do face to face or telehealth and you need to add the telehealth modifer then follow the next steps.

  • If you have received a new authorization specifically for telehealth you will need to add a new service and add modifier accordingly.

ADD Modifiers

Select “Yes” to the question:

“Do you want to restrict which staff can provide this service or bill multiple rates for this service?”

 

 

SELECT Credentials and ADD modifiers

** IF YOU ARE LOOKING TO ADD MODIFIERS FOR TELEHEALTH - START HERE**:

To add the same credential with different modifiers, you will need to add the same credential TWO TIMES:

Start by Selecting the “+” to ADD any applicable credentials to this billing code:

Then you will see the option to enter in the billing rate , modifiers as well as a “Modifier 2 Name”:

 

  • When adding the telehealth modifiers to your system you have 2 options. Please reference your payor requirements prior to updating your system.

    • Option 1: add the telehealth modifier to existing billing codes in your system (follow the instructions outlined here)

      • THIS IS THE OPTION THAT WILL NOT REQUIRE UPDATING CLIENT AUTHORIZATIONS

    • Option 2: add NEW billing codes for telehealth to your funders

You will need to assign the new service/code to a client authorization.

 

  • The Modifer 2 Name allows staff scheduling to differentiate which line to select.

  • IF you are adding in the telehealth modifier to your billing codes, you will need to duplicate each applicable credential that can continue to provide the service as entered AND able to provide telehealth services

    • if only some credentials can provide telehealth services, then you will only need to duplicate those applicable credentials

  • The system will allow each credential to be added to the system two times, if you do need to add the same credential more than two times - then you will need to enter these as as a separate billing code

  • The “Modifier 2 Name” is what will display when staff are scheduling - in addition to the original billing code service name

 

SCHEDULING

The Modifier 2 Name will be an option at the SCHEDULING LEVEL in addition to the ORIGINAL BILLING CODE SERVICE NAME:

SELECT the appropriate service depending on which modifier details are needed:

 

  • Client authorizations will not be impacted by adding a Modifier 2 Name, this will ONLY be an option to be selected at the SCHEDULING level

  • Access to the billing code will remain restricted BY THE STAFF CREDENTIAL

 

INDICATE Place of Service:

If your funder requires a telehealth indication at the Place of Service - that can be found at the bottom of the Place of Service options in the drop down list:

SELECT 02- Telehealth

 

  • Be sure to check in with your funding sources on IF they will require a different place of service selection and then advise your staff on the correct selection

Session Note “Location” selections

IF you currently use a checkbox within your session note template to indicate the location of services, you may want to add in a “Remote” or “Telehealth” location option:

Go To Client Report Templates:

Open your applicable session note template:

Find to your Location of Service check box

ADD a “REMOTE” or “Telehealth” selection to the options

Click SAVE then SAVE the client report template

  • If you currently require a parent signature in your session notes, you may also find it helpful to remove the required selection on the “parent digital signature” field