Health Net Federal Services, LLC (HNFS), who is the TRICARE West Region Contractor, has provided an update on what place of service (POS) code to use on the 1500-claim form when providing a telehealth visit. HNFS is now asking providers to use the POS that represents
In addition, HNFS has provided an update on reimbursement and resubmission of claims. By using an incorrect POS code, the provider may have been or will be reimbursed at the facility CHAMPUS Maximum Allowable Charge (CMAC) rate, rather than a non-facility CMAC. If you provided telemedicine services from a non-facility setting, you may submit a corrected claim with the actual HIPAA POS to ensure claims are adjusted and paid at the appropriate reimbursement level. HNFS is unable to automatically adjust claims as the POS will vary from provider to provider.
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