This article has been updated on Dec 01, 2022 by ... What are the new phone and video virtual service codes effective Dec.01,2022?

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How do physicians qualify for telemedicine?

How do I bill an OTN service?

First enter OTN in the SLI field.

The OTN Screening Service Codes (effective April 1, 2020): 

B103A:
$0.00 Hosted video visit – patient attending at a patient host site
Synchronous video visits with a patient who is physically located and supported at a patient host site during the clinical encounter.

B203A:
$0.00 Direct-to-Patient Video Visit
Synchronous video visits with a patient in the home or another location of their choice (i.e. the patient is not at a patient host site).

The OTN codes that were effective PRIOR to April 1, 2020

1. Premium Service Fee Codes that follow procedure service codes 
   
   1. B100A: $35.00 First Telemedicine Patient Encounter premium (formerly OTN1) 
   2. B200A: $15.00 Subsequent Telemedicine Patient Encounter premium (formerly OTN2) 
2. Premium Fee Service Codes that are billed on their own
   
   1. B101A: $35.00 First Cancelled/Missed Telemedicine Patient Encounter premium* 
   2. B201A: $15.00 Subsequent Missed/Cancelled Telemedicine Patient Encounter premium* 
   3. B102A: $35.00 First Technical Difficulties Abandoned Patient Encounter premium* 
   4. B202A: $15.00 Subsequent Technical Difficulties Abandoned Patient Encounter premium* 

* Services cannot be billed in addition to the premiums for a missed, cancelled, or abandoned session. 

There are eleven Rejection codes applicable to telemedicine billings: 

1. ET1: Provider Not Registered for Telemedicine Program; 
2. ET4: Telemedicine Premium/Tracking Code Missing; 
3. ET5: Telemedicine SLI Code Missing or Invalid;
4. TM1: Duplicate Telemedicine Claim for Same Patient; 
5. TM2: Service Not Billable for Missed/Cancelled/Abandoned Appointment;
6. TM3: Service Not Payable Under Telemedicine Program; 
7. TM4: Non-Telemedicine Claim Already Paid for This Patient; 
8. TM5: Telemedicine Claim Already Paid for This Patient; and 
9. TM6: Telemedicine Registration Not in Effect on Service Date. 
10. TM7: Dental Services Not Payable Under Telemedicine Program;
11. TM8: Provider Not Eligible for Store Forward Telemedicine Services 

For more information read bulletin 4750 here . . .