CMS announces new telehealth modifier for stroke patients

CMS recently released Transmittal 2142, announcing a new HCPCS telehealth modifier effective for claims submitted on or after January 1.

The Bipartisan Budget Act of 2018 removed restrictions on the geographic locations and the types of originating sites where acute stroke telehealth services can be furnished under Medicare. As a result, in 2019, telehealth services for stroke patients will be covered by Medicare for both rural and urban hospitals alike.

To accommodate this change, informational HCPCS modifier -G0 was created to identify telehealth services furnished for purposes of the diagnosis, evaluation, or treatment of symptoms of an acute stroke.

Modifier -G0 will be used for all telehealth distant site codes billed under Medicare with Place of Service code 02 or revenue codes 096X, 097X, or 098X for professional fees. The modifier will also be used for Medicare claims with HCPCS code Q3014 for telehealth originating site facility fees.

Practitioners will be responsible for assessing whether it is clinically appropriate to use this modifier.

For more information on the new modifier, see MLN Matters number MM10883.