Place of Service 02 in Medical Billing:
Place of Service 02 is also known as POS 02 in medical billing. When the services performed through telecommunication system, then it is indicated by using place of service 02.
POS 02 – Telehealth or Telemedicine Description?
POS 02 is indicated, when the method of delivering the medical services to the patient using telecommunication system.
Let us see the definition of Telehealth in order to understand the usage of place of service 02 in medical billing.
Telehealth: For enhancing the patient health condition, medical information is exchanged via electronic system from one place to another place and this is called as Teleheath or Telemedicine services. Getting reimbursed for telehealth services is little complicated, because the reimbursement guidelines for telehealth services vary based on the insurances.
Requirement for Medicare insurance, for reporting the place of service 02 (Telehealth or Telemedicnie):
We need to meet and follow the below guidelines for Medicare, before reporting the place of service 02:
- Patient cannot be in their home or office when the service is rendered they must be located in a qualifying rural originating site and a provider located in distant site.
- Qualifying rural originating site such as a clinic/physician office or may be a specified medical facility.
- The distant site provider will bill their service with place of service 02.
- Modifier GT is no longer used for Medicare on professional claims, when reported with place of service 02.
- Most payers follow the Medicare guidelines.
- It is better to call the respective payer you are billing the claim and check their policy for telehealth services. Because some commercial payers require adding Modifier 95 with the place of service 02, when synchronous telemedicine service rendered via real time interactive audio and video telecommunication system. So whenever billing the telehealth services for commercial payers, please check their guidelines to report correctly.
- If a service billed with place of service 02 and the procedure code is not designated as a covered telehealth service, the payers will deny the telehealth claims submitted.
- Some payers wants to submit the claim to them with Modifier GQ, when the telehealth services provided via asynchronous telecommunication system and Modifier GT should be used, when the telehealth services provided via interactive audio and video telecommunication system.
Frequently asked question on place of service 02 :
Does modifier GT required on professional claims for Medicare, when we use place of service 02?
Answer: Do not use modifier GT, it’s no longer required on professional claims when reported with place of service 02 for Medicare. Only the place of service 02 is indicated for reimbursement of professional claims from Medicare for Telehealth services.
Conclusion on usage of place of service 02:
Assume you have met all the general guidelines and requirement for telemedicine (For example, one of the important is patient not in home or patient place of employment and they are located at the qualified originating site and provider is a qualified distant site provider), then you bill the claim same as you would for a face to face service and with place of service 02 (For commercial insurance you use modifier 95).