Question
Does TRICARE pay for telehealth services for outpatient physical, occupational and/or speech therapy services?
Answer
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Question
What CPT code(s) do I use to bill for telehealth for TRICARE beneficiaries?
Answer
The TRICARE Policy Manual is not clear on what code(s) to use for telehealth services. Your first option is to contact TRICARE.
Per the TRICARE Policy Manual, April 2015, Change 60 (March 13, 2020), Chapter 7, Medicine, Section 2.3.2.3, it states the following: “When billing for synchronous telemedicine services, providers will use CPT or HCPCS codes with a GT modifier for distant site and Q3014 for originating site to distinguish telemedicine services. In addition, Place of Service POS 02 is to be reported in conjunction with GT modifier. By coding and billing the GT modifier with a covered telemedicine procedure code, the distant site provider certifies that the beneficiary was present at an eligible originating site when the telemedicine service was furnished.”
TRICARE may or may not pay for the CPT codes commonly used by physical therapists, occupational therapists or speech-language pathologists that are found in the 92000 and 97000 series when billed with the GT modifier and Place of Service code 02.[/restrict]
Question
Is preauthorization required for telehealth services?
Answer
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Question
If I have additional questions or I want to contact my TRICARE Regional Contractor, how can I do that?
Answer
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TRICARE has 2 Regional Contractors. Health Net Federal Services is responsible for the West Region and Humana Military is responsible for the East Region.
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