Configure PCC EHR for Telemedicine Encounters

Read the sections below to learn how to configure PCC EHR for telemedicine encounters.

Read or Watch a Telemedicine Procedure in PCC EHR: How will your front desk, clinicians, and billers perform telemedicine in PCC EHR? Before you dive into the configuration options below, read or watch Schedule, Chart, or Bill a Telemedicine Encounter in PCC EHR (watch video, read article).

Create Telemedicine Visit Reasons for Scheduling

When you schedule, perform, or bill a telemedicine visit, it should be clear to everyone at your practice that the encounter is happening remotely.

Open the Visit Reasons Editor from the Configuration menu and create one or more visit reasons for telemedicine.

Click “Add” to create a new visit reason. You can name the visit reason, indicate the Visit Type (for helping schedulers pick appropriate times), set whether your practice should print paper forms for the visit, and set both a default duration and optional specific default durations for each clinician.

If your practice commonly performs sick visit and ADHD telemedicine visits, you could create a visit reason (and an accompanying chart note protocol) for each type of visit.

Select Your Telemedicine Vendor

Your practice can choose from a wide range of telemedicine vendors.

PCC has done some research and developed a list of telemedicine vendor options that we believe can provide efficient, safe, and reliable interactions with your patients and families.

Once you’ve chosen a vendor, your practice will need to figure out your workflow for connecting to visits.

Configure Telemedicine Links for Your Providers and Patients

If everyone in your practice is using the same tool, and the vendor supports it, you may have a persistent set of URL web addresses that patients and providers can use to connect.

You can enter those addresses in Practice Preferences.

If you have persistent links for patients, you can enter them in the Patient Access fields

Your practice can then quickly select a link when they schedule or edit appointments.

If you have a persistent link for provider access, you can enter it in the Provider Access field.

Both the provider and patient links will appear at the top of the chart note protocol for a telemedicine visit.

Add New Visit Statuses to Help Manage Telemedicine Visits

The Visit Status on the Schedule screen (and the Visit Status counters in the lower-right corner of your screen) help your practice track what’s going on with all of today’s encounters.

Your practice can create one or more custom Visit Statuses to help understand the status of telemedicine encounters.

Open Visit Status Configuration from the Configuration menu and create one or more visit statuses for telemedicine.

Your practice can use visit statuses so everyone at your practice can know who is on hold, who’s connected, and who is waiting for the provider to join the video chat.

Create a Telemedicine Visit Protocol

In PCC EHR, you can create and customize chart note protocols for different visit types. PCC recommends you create a “Telemedicine Sick” protocol, along with other telemedicine-based protocols you expect to schedule. You can then have that protocol appear automatically for Telemedicine visits.

You can include any typical component in your chart note protocol, and you may want to create custom components or new orders that relate specifically to the types of services that will occur as a result of a telemedicine visit.

To learn how to create and customize a Telemedicine protocol, and find out what other pediatricians are making, read Create a Telemedicine Chart Note Protocol.

Add Telemedicine Procedure Codes and Prices to Your PCC System

Before you can code and bill for telemedicine procedures, you need to add those procedures to your PCC system, along with codes and your practice’s prices.

Create a Telemedicine Procedure Group

If you create a telehealth or telemedicine procedure group, you can easily report on telemedicine A/R and income. You should perform this step first so you can select the group when you create new procedures.

For more help in setting up new procedure groups, contact PCC Support.

Add Telemedicine Procedures, Codes, and Prices

Next, add new telemedicine procedures to your PCC system. Include codes (with modifiers, if appropriate) and prices.

What procedures are currently in use? Your practice may need to consult with insurance payers to understand how to code for telemedicine procedures. PCC recently published a Guide to COVID-19 Billing Codes, which includes full descriptions of different types of telemedicine visits and how to code for them. PCC also created a Telemedicine Timing reference sheet.

Examples:

• Telephone Service Codes: Use the time-based 99441-99443 for Telephone E&M performed by a MD, DO, NP, or PA. Use 98966-98968 for A&M performed by a RN or MA.

• Realtime Audio/Video Visit Codes: Use 99211-95 through 99215-95 for live or “synchronous” telemedicine services with realtime audio and video. Note that some payers use a -GT modifier instead of -95 for asynchronous communication (sending and receiving video messages).

Read Edit Your Practices Codes and Prices to learn how to add new billing procedures to your PCC system.

Update Your Electronic Encounter Form w/ Telemedicine Billing Codes

When your clinician is ready to make a visit “Ready for Billing”, they’ll need the right visit codes easily available for a telemedicine visit.

Open Billing Configuration under the Configuration menu and add procedures (and optionally diagnoses) to your practice’s Electronic Encounter Form.

Configure Your Practice’s Telemedicine Places of Service

When you submit a claim for a telemedicine encounter, you need to include a different Place of Service code than for a standard office visit. For example, an “in-office” visit appears on claims with a place of service code of 11, and telemedicine encounters typically need an 02 or a 10.

In PCC EHR, you can schedule all of a provider’s time in your real-world, office locations. You can configure your system with additional telemedicine places of service and automatically select them when billing for telemedicine encounters. When needed, your biller can change the place of service as they post charges or later in the patient’s Billing History.

Video: Watch Configure Your Telemedicine Place of Service Codes for a video example of configuring places of service for telemedicine.

Which POS Codes Are Used for Telemedicine Encounters?

CMS defines these two telemedicine place of service (POS) codes:

1. POS 02: Telehealth Provided Other than in Patient’s Home

   Descriptor: The location where health services and health related services are provided or received, through telecommunication technology. Patient is not located in their home when receiving health services or health related services through telecommunication technology.

2. POS 10: Telehealth Provided in Patient’s Home

   Descriptor: The location where health services and health related services are provided or received through telecommunication technology. Patient is located in their home (which is a location other than a hospital or other facility where the patient receives care in a private residence) when receiving health services or health related services through telecommunication technology.

For more details, you can review the full CMS Place of Service Code Set.

Create Telemedicine Places of Service for Your Physical Locations

To create telemedicine places of service for an existing physical location, clone the location and give it a telemedicine name and POS code.

Run the Table Editor (ted) in your Practice Management window and visit table 15, “Places of Service”.

Clone your main office location and adjust the POS Name, Short Name, and the Default and HIPAA codes.

The Default code is typically used on paper claims, and the HIPAA code is typically used on electronic claims. The various Schedule codes are used for special configuration needs by individual payers. As with other claim requirements, check with your carriers to determine billing requirements. For example, some payers may require an 11, 10, or 02 place of service code for telemedicine visits, depending on circumstances. PCC can also help you configure schedules so the correct place of service appears on claims.

Also: always use the full address with a “zip +4” code for places of service.

Repeat the process above for any physical location where you also bill for telemedicine encounters. If you need to designate “at home” and “not at home” separately, create additional places of service for the 10 and 02 codes.

Set Default Billing Places of Service for Telemedicine Encounters

When you schedule a telemedicine visit, use your real-world physical office location in the Appointment Book. Then your doctors can see their whole schedule, and your practice can see what’s happening that day at a glance.

When it’s time to bill, as noted above, payers typically require a special telemedicine place of service on the claim. It’s cumbersome to manually switch the place service each time you post telemedicine visit charges. To make posting easier, you can set a default billing place of service for telemedicine encounters for each of your scheduling locations. Follow the procedure below to learn how.

If you encounter a billing problem with a telemedicine encounter, you can also change the place of service later and queue up a new claim using the Edit Charges feature of the Billing History in the patient’s chart.