The analysis of any legal or medical billing is dependent on numerous specific facts — including the factual situations present related to the patients, the practice, the professionals and the medical services and advice. Additionally, laws and regulations and insurance and payer policies are subject to change. The information that has been accurate previously can be particularly dependent on changes in time or circumstances. The information contained in this web site is intended as general information only. It is not intended to serve as medical, health, legal or financial advice or as a substitute for professional advice of a medical coding professional, healthcare consultant, physician or medical professional, legal counsel, accountant or financial advisor. If you have a question about a specific matter, you should contact a professional advisor directly. CPT copyright American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association.
Cigna Telehealth Policy PT and OT
PT/OT/ST providers can now deliver virtual care for any service if it is on their current fee schedule and if CMS covers it virtually. We have removed the previous guidance that only a select number of codes on the fee schedule could be billed. PT/OT/ST providers should also submit virtual claims with a GQ, GT, or 95 modifier and a face-to-face place of service code (e.g., POS 11).
Additionally, if a provider typically bills services on a UB-04 claim form, they can also provide those services virtually. In these cases, the provider should bill as normal on a UB-04 claim form with the appropriate revenue code and procedure code, and also append the GQ, GT, or 95 modifier.