If you plan to provide telehealth services to diagnose, evaluate or treat symptoms of an acute stroke next year, take note of a new modifier Medicare has introduced that should be appended to these services.
Modifier G0 (Telehealth services for diagnosis, evaluation, or treatment, of symptoms of an acute stroke) takes effect Jan. 1. Note: This is G-zero, not G-letter O, the existing modifier for Services delivered under an outpatient occupational therapy plan of care.)
G0 should be appended to both:
- The distant site codes* billed with place-of-service code 02 (Telehealth) and
- HCPCS code Q3014 for Telehealth originating site facility fee.
The Balanced Budget Act of 2018 removed the restrictions on the geographic locations and types of originating sites where telehealth stroke services could be provided. CMS announced the new modifier in
Change Request 11043 and MLN matters article
MM11043.
Now these services can be done in any hospital, critical access hospital, mobile stroke unit or any other site CMS deems appropriate, in addition to currently eligible telehealth originating sites, according to the final Medicare physician fee schedule.
Appending modifier G0 ensures that the MAC will reimburse the telehealth services performed in the expanded list of origination sites, some of which are not currently available for non-stroke related telehealth services.
*Medicare’s list of
distant site codes includes a mix of CPT E/M codes and telehealth consultation G codes.