Informational Bulletin 20-5: COVID-19 Provider Update (revised 5.6.22)
Date: 05/09/22
On May 6, 2022, Louisiana Department of Health released a revision to Informational Bulletin 20-5: COVID-19 Provider Update (PDF).
Revisions include:
Billing Instructions (non-FQHC/RHC):
Providers must indicate the appropriate place of service, either 02 (other than home) or 10 (home), based on the beneficiary’s location at the time of service and must append modifier - 95. Services delivered via an audio/video system and via an audio-only system are to be coded this same way.
Billing Instructions for FQHCs/RHCs:
Providers must indicate the appropriate place of service 02 (other than home) or 10 (home), based on the beneficiary’s location at the time of service and must append modifier -95 on the header and on all detailed service lines. Services delivered via an audio/video system and via an audio-only system are to be coded this same way. Reimbursement for these services in an FQHC/RHC will be at the all-inclusive prospective payment rate on file for the date of service.
Billing and Claims Processing Update:
The Louisiana Medicaid fee-for-service (FFS) claim processing system is being updated to allow the appropriate teletherapy place of service code, either 02 (other than home) or 10 (home), based on the beneficiary’s location at the time of service in addition to the procedure modifier 95.
All Therapy Providers
A list of relevant procedure codes is included below. Providers must indicate the appropriate place of service, either 02 (other than home) or 10 (home), based on the beneficiary’s location at the time of service and must append modifier -95.
Billing Instructions:
Claims processing systems were updated by March 24, 2020. In addition to providing a CPT code, providers must indicate the appropriate place of service, either 02 (other than home) or 10 (home), based on the beneficiary’s location at the time of service and must append modifier -95. Services delivered via an audio/video system and via and audio-only system are to be coded this same way.
Telehealth at Outpatient Hospital Facility
Effective for dates of service on or after March 17, 2020, outpatient hospital facilities must bill telehealth claims using the normal revenue code and applicable procedure code with modifier 95 appended. The POS 02 (other than home) or 10 (home) telehealth guidance for professional claims does not apply for telehealth billing on the UB 04 Form.
Secondary Claims (Third Party Liability – TPL) for Telehealth
If a primary insurance claim for telehealth services was submitted with a place of service equal to the primary carrier’s billing requirements and modifier -95 is appended to the procedure code for a covered service, Gainwell Technologies will allow the secondary claims and encounters. Place of service (POS) 02 (other than home) or 10 (home) will not be required for these claims. This instruction also applies to MCOs.
Coding for EPSDT preventive services completed through telemedicine/telehealth and interperiodic visits:
- Telemedicine/telehealth visit: Normal EPSDT preventive services code by age (99381- 99385, 99391-99395) with telehealth modifier (95), reduced services modifier (52), and the appropriate place of service, either 02 (other than home) or 10 (home), based on the beneficiary’s location at the time of service.
- In-person interperiodic visit: Normal EPSDT preventive services code (99391-99395).
Providers are encouraged to review the entire Informational Bulletin (PDF) for additional information.