COVID-19 Telemedicine Billing Guidance from All Medicaid Health Plans

Date: 03/25/20

Expanded telehealth access for Medicaid enrollees was announced in the recent LDH Provider Notice on Novel Coronavirus Disease (COVID-19). 

In order to prevent unnecessary telemedicine denials during the COVID-19 crisis, the five Medicaid health plans are issuing this combined guidance on telemedicine billing. This aligns with the LDH Provider Notice and offers this information in an easy to reference format. 

• Both the POS 02 and modifier 95 MUST be used in the applicable fields on each claim line to ensure it will pay appropriately.
• All other required modifiers must also be included on the claim form. Examples include therapy modifier, MHR modifiers, etc…
• RHC and FQHC providers billing telemedicine services are required to use Place of Service (POS) 02 with modifier 95 and NOT POS 50 for FQHC’s or POS 72 for RHC’s.
• Lab Codes should not be billed with POS 02 and are not allowed to be performed via telemedicine. Please reference CMS guidelines for acceptable POS codes for laboratory services. 
• To submit a corrected claim use frequency code 7.