Telehealth services added by CMS; CLIA-waived test list expanded


Learn about the telehealth services that Medicare added for 2011.

A: The Centers for Medicare and Medicaid Services (CMS) added the following services to the list of Medicare telehealth services:

Use the following codes for the specific services provided:

• Individual and group DSMT services (with a minimum of 1 hour of in-person instruction to be furnished in the initial year training period to ensure effective injection training)

• Group MNT and HBAI services

• Subsequent hospital care services (with the limitation of one telehealth visit every 3 days)

• Subsequent nursing facility care services (with the limitation of one telehealth visit every 30 days)

Remember that the frequency limitations on subsequent hospital care and subsequent nursing facility care delivered through telehealth do not apply to inpatient telehealth consultations.

Also, consulting practitioners should continue to use the inpatient telehealth consultation codes (G0406, G0407, G0408, G0425, G0426, or G0427) when reporting consultations furnished via telehealth.

For dates of service on or after January 1, 2011, Medicare contractors will accept and pay the added codes according to the appropriate physician or practitioner fee schedule amount when submitted with a GQ or GT modifier.


Q: Our office is trying to update its list of Clinical Laboratory Improvement Amendments (CLIA)-waived tests. Can you give us any updates?

The author is a medical consultant based in Indianapolis, Indiana. Do you have a primary care-related coding question you would like to have our experts answer in this column? Send it to

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