Telehealth services: Billing changes coming in 2022

Psychologists providing telehealth services to Medicare beneficiaries will see a change in the point of service (POS) codes used to file claims starting in 2022, the Centers for Medicare and Medicaid Services announced October 13 (PDF, 189KB)opens in new window. POS codes are required on health care claims to inform third-party payers, such as Medicare, where the service was rendered.

Effective January 1, 2022, POS code 02 will be revised, and a new POS code 10 will be created. When providing telehealth services to patients in their own homes, psychologists will start using POS code 10 and stop using POS code 02.

POS code 10 does not apply to patients who are in a hospital or other facility where the patient receives care in a private residence, such as a nursing home or assisted living facility.  In those situations, psychologists will continue to use POS 02.

A data snapshot released by the Office of the Inspector General (OIG) of the U.S. Department of Health and Human Services looked at the use of telehealth services by Medicare beneficiaries from March to December 2020. The OIG’s analysis found that 78% of beneficiaries receiving psychotherapy services during the public health emergency (PHE) in 2020 already had an established relationship with the provider.

Breaking the data down further, 79% of the beneficiaries on traditional, fee-for-service Medicare and 74% of the beneficiaries covered by Medicare Advantage plans had an established relationship with the provider furnishing psychotherapy via telehealth.

On average, beneficiaries receiving psychotherapy services through telehealth during the PHE had participated in at least one in-person visit with the provider about three months before the first telehealth visit.

The OIG’s telehealth data snapshot (PDF, 838KB)opens in new window is available online.