Q&A: Billing for outpatient therapy services
Q: During the public health emergency, are outpatient therapy services provided to a patient located in their home or a clinic billed in the same way as outpatient therapy services provided to a patient whose home has been designated a provider-based department (PBD)?
A: For the duration of the public health emergency, a hospital may bill outpatient therapy services in two ways:
- As Category 1 remote services, if the patient is registered as an outpatient and the patient’s home is made a PBD to the hospital
- Via telehealth with modifier -95 attached, without making the patient’s home a PBD to the hospital/CAH
In either case, payment will be what it would have been if services had been delivered in the normal setting.
For more information, see "Note from the instructor: Creative delivery of outpatient hospital services during the COVID-19 PHE, Part II" by Judith Kares, JD.