Billing and Payment for Distant Site Professional Fee

Claims for distant site telehealth services are submitted to the Part B MAC that processes claims for the performing physician/practitioner’s service area. Physicians/practitioners submit the appropriate HCPCS procedure code for covered professional telehealth services with POS code 02 (Telehealth) on a CMS-1500 claim form or electronic equivalent.

CAHs Method II are the only Part A providers that may include a charge for a distant site on the UB-04 claim form:

• Revenue codes 096X, 097X and 098X
• A/B/MACs (A) make payment for telehealth services provided by the physician or practitioner at 80 percent of the Medicare Physician Fee Schedule (MPFS) facility amount for the distant site service
• Only time distant site practitioner services billed to Part A