Telehealth/Telemedicine Enrollment

Telehealth and/or Telemedicine is the use of telecommunications technology to provide health care services to persons who are at some distance from the provider. It involves a spectrum of technologies. To access Telehealth vs Telemedicine, Distant Site, Originating Site, Eligible Providers, Eligible Services, Acceptable Equipment, Billing, Federal Demonstration Project information, go to the Telehealth/Telemedicine webpage.

Update - Telehealth Reporting of Home Location During the PHE, CMS allowed practitioners to render telehealth services from their home without reporting their home address on their Medicare enrollment while continuing to bill from their currently enrolled location. This flexibility will be extended, consistent with the calendar year (CY) 2024 Physician Fee Schedule (PFS) final rule which extends the telehealth policy to allow physicians and practitioners who bill for Medicare telehealth services to report the place of service (POS) code that would have been reported had the service been furnished in person, through December 31, 2024.

View the below telehealth/telemedicine enrollment related information on this page.

Group Billing for their Reassignments

  • Group must have an approved enrollment record in the state where the provider is providing the services
  • Group must add the providers location as a practice location on their enrollment
    • This cannot include: privately owned boat, hotel room or car
    • The office must be a physical location where services are rendered
  • Provider must then reassign benefits to the group
  • Provider must be licensed in state where the services are provided

Example: If patient is seen in California and x-ray reading is out of Florida, then group must establish a practice location in Florida and provider must be reassigned newly established group enrollment in Florida. Provider must be licensed in Florida.

Applications needed

  • Group will submit an 855B to initially enroll or add the location in the state the provider rendering services
  • Provider will submit an 855I to reassign to the group
    • If the provider is not actively enrolled, or new to Medicare; an 855I will need to be submitted
  • All of these updates can be completed via PECOS or Paper

Sole Proprietor

  • Sole Proprietor who bills Telehealth/Telemedicine must enroll the practice location where the services are rendered
  • Provider will set up a practice location with either his/her home as the practice location or a rented/leased office space where the services are rendered
  • Provider must be licensed in state where the services are rendered
  • Example: If patient is seen in California and provider is rendering services in Florida, the provider must enroll in Florida and add that practice location to their enrollment

Applications needed

  • Provider will submit an 855I application to the correct MAC
  • This can be completed via paper or PECOS

Resources

 

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