News & Information

MLN released information stating they have eliminated the requirement to use modifier GT on Telehealth services.

As a result of eliminating the need for the GT modifier Medicare now requires the use of a POS Code 02 to describe services furnished via telehealth.

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Anthems original plan was to take a 50% reduction when providers reported claims using modifier 25, it was then lowered to a 25% reduction and has now been fully rescinded, to the relief of providers.  The policy was to go into effect March 1, 2018, however, due to strong opposition from the American Medical Association and other groups Anthem decided it was not in the best interest between payers and providers. 

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Whenever there is a high-cost item, CMS has historically evaluated usage to determine appropriateness of billing and this is another example. A Decision Memo was released on February 15, 2018 which included the following changes:

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Two recent reports should make providers stop, take notice and make sure their practice's policies and procedures are up-to-date.

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Q: Can two untimed codes be performed at the same time? For instance can I perform lumbar traction (97012) at the same time as e-stim (97014)?

A: Please click on the link: https://www.chirocode.com/blog/241

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