Teleheath: Therabill Standalone

Therabill supports the documentation and billing of therapy services provided through telehealth.

For the duration of the COVID-19 emergency, Medicare has authorized PTs, OTs, and SLPs to deliver and receive reimbursement for telehealth services. Because commercial payers act independently, we recommend contacting payers to determine individual payers rules. To learn more about this recent update, click here.

Important: This article applies to Therabill Standalone members. If you are WebPT EMR + Therabill, click here for instructions. 

To document and bill for telehealth, you’ll need to complete the following steps when creating the client’s session. 

1. Select Telehealth (02) as the place code.
2. Include the appropriate telehealth service code and add it to your insurance settings (if using).
3. Include the appropriate Modifier (if using).

1. Telehealth Place of Service Code

When entering a new session for the client’s telehealth visit, select Telehealth (02) from the Place Code drop-down in the Billing & Coding section. 

2. Telehealth Service Codes

98966, 98967, and 98968 are telehealth CPT® codes—though not specific to rehab therapy—and should be chosen based on the duration of the telehealth appointment as follows:

• 98966: 5–10 minutes
• 98967: 11–20 minutes
• 98968: 21–30 minutes 

Medicare Standard Services during the Public Health Emergency

For the duration of the COVID-19 emergency, Medicare has authorized PTs, OTs, and SLPs to deliver and receive reimbursement for telehealth services. Because commercial payers act independently, we recommend contacting payers directly for information regarding the specific coverage for each client. To learn more about this recent update, click here.

Services that were provided as of March 1, 2020 through the end of the public health emergency are eligible to be billed and reimbursed as telehealth services. This means you are allowed to bill standard codes that are not telehealth specific for Medicare. 

Covered codes include:

• 97161-97168: Initial evaluations and re-evaluations
• 97110: Therapeutic exercise
• 97112: Neuromuscular re-education
• 97116: Gait training
• 97535: Self-care/home management training
• 97750: Physical performance test or measurement
• 97755: Assistive technology assessment
• 97760: Orthotics management and training
• 97761: Prosthetic training, upper and/or lower extremities, initial prosthetic encounter
• 92521-92524: Speech/language evaluations
• 92507: Speech/language treatment

Medicare Standard Services POS Codes and Modifiers:

• Place of Service code that would apply if the service had been furnished in person
• 95: Synchronous Telemedicine Service Rendered via a Real-Time Interactive Audio and Video Telecommunications System (effective January 1, 2017). The use of this modifier indicates a real-time interaction between a physician—or other qualified healthcare professional—and a patient located at another site.
• GP/GO/GN modifier

Add the Telehealth Service Code to the Session

1. From the client’s session, enter the appropriate code into the Service Code field.
2. Select the code from the drop-down.
3. Note: If you would like the Charge field to populate, you can add the code to your Fee Schedule.

Adding a Service Code to Therabill

Before billing the client’s insurance for the session, you must add the chosen CPT code to the payer. Note: This is a one-time setup and only needs to be completed for the payer(s) you plan on billing for telehealth services.

1. Hover over Billing and select Insurance List.
2. Locate the client’s insurance and click Info & Settings.
3. Click on the Advanced tab.
4. Click Add Code.
   
   
5. Input the code and click Add.
   
   
6. You can now bill this service code to the payer.

3. Telehealth Modifiers

Each service submitted for a telehealth visit must have one of the following modifiers appended to the procedure code:

• 95: Synchronous Telemedicine Service Rendered via a Real-Time Interactive Audio and Video Telecommunications System (effective January 1, 2017). The use of this modifier indicates a real-time interaction between a physician—or other qualified healthcare professional—and a client located at another site.
• GT: Via interactive audio and video telecommunication systems. The use of this modifier certifies that the provider was present at an eligible originating site when the telehealth service was rendered.
• GQ: Via Asynchronous telecommunications system. The use of this modifier certifies that the asynchronous medical file was collected and transmitted to a provider at a distant site (store and forward technologies).

Adding a New Modifier in Therabill

To add a new modifier in Therabill, simply type the modifier into the Billing & Coding section of the client’s session.