Telehealth - JF Part B
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.
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
- 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 855R 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
- 42 CFR Part 410.78 - Telehealth Services background information
- CMS Internet Only Manual (IOM), Publication 100-02, Medicare Benefit Policy Manual, Chapter 5
- CMS IOM, Publication 100-04, Medicare Claims Processing Manual Chapter 12
- CMS IOM, Publication 100-04, Medicare Claim Processing Manual, Chapter 12, Section 190
- CMS Telehealth Website
- Telehealth Service Booklet
Last Updated Fri, 09 Dec 2022 17:37:48 +0000