Resolved Place of Service for Amblyopia

[MICHELLEK_76201]

Hello,

I would like to know what are the payable POS for HCPCs codes 0704T, 0705T, and 0706T for remote service.

Thanks,
Michelle

 

[Alicia]

Here is the first step. Where is the fact-to-face service?
The CMS ruling instructs providers to use the place of service that represents the setting in which the beneficiary received the face-to-face service. Unless a provider has a separately maintained office space in the hospital or medical campus where the services was rendered, the POS is considered “outpatient hospital” and must show POS code 22.

You may wonder why using POS code 11 instead of 22 makes a difference. For services paid under the MPFS, there is a reduced reimbursement of procedures billed by providers in the outpatient hospital department. This reduction is based upon the facillity bearing the costs, such as support staff and equipment, that are required for the services to be rendered instead of the provider. Therefore, providers that incorrectly submit POS code 11 are being overpaid for their outpatient hospital procedures, and if audited, are subject to paying refunds to Medicare.
So what about "Remote"?
POS 02 or POS 10
Here is your answer: https://www.cms.gov/files/document/mm12427-newmodifications-place-service-pos-codes-telehealth.pdf

 

[MICHELLEK_76201]

thank you

 

[Alicia]

Your welcome. This is a great question with so much remote work being done now.