Telehealth POS 02 & 10 Clarification

Date: 02/11/22

Effective for dates of service 1/1/22 and after, CMS revised the description of POS code 02 and added POS 10 for telehealth services to meet the overall industry needs. This communication provides the description of these two codes and billing guidance for both Medicare and Medicaid.

POS	Line of Business	Description	Billing Guidance
02	Medicare	POS 02: Telehealth Provided Other than in Patient’s Home Patient is not located in their home when receiving health services or health related services through telecommunication technology	· Following CMS guidance, POS 02 and 10 are effective 1/1/22 and will be implemented in systems as of 4/4/22. · As a result, claims adjudication for POS 02 and 10 will begin 4/4/22 for dates of service 1/1/22 and forward. · Please don’t hold your claims though; please submit so you avoid timely filing denials. If you submit a claim with POS 10 for a date of service prior to 4/4/22, it will not be able to be reimbursed but you may later submit a corrected claim, which will be reimbursed.
10	Medicare	POS 10: Telehealth Provided in Patient’s Home Patient is located in their home (which is a location other than a hospital or other facility where patient receives care in a private residence) when receiving health services or health related services through telecommunication technology

POS

Line of Business

Description

Billing Guidance

Medicare

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

Patient is not located in their home when receiving health services or health related services through telecommunication technology

· Following CMS guidance, POS 02 and 10 are effective 1/1/22 and will be implemented in systems as of 4/4/22.

· As a result, claims adjudication for POS 02 and 10 will begin 4/4/22 for dates of service 1/1/22 and forward.

· Please don’t hold your claims though; please submit so you avoid timely filing denials. If you submit a claim with POS 10 for a date of service prior to 4/4/22, it will not be able to be reimbursed but you may later submit a corrected claim, which will be reimbursed.

Medicare

POS 10: Telehealth Provided in Patient’s Home

Patient is located in their home (which is a location other than a hospital or other facility where patient receives care in a private residence) when receiving health services or health related services through telecommunication technology

CMS: For more information, please see CMS’ MLN Matters release

POS	Line of Business	Description	Billing Guidance
02	Medicaid	Same as above	· AHCCCS is not utilizing POS 02 or 10 for its Telehealth approved codes. · Effective 1/1/2022, AHCCCS requires that the POS billed on the claim be assigned based on the location of the member at the time of service. Example: If you complete an office visit via telehealth using interactive audio + video and the member was in their home at the time of the visit and the provider was in their office, you might bill:
10	Medicaid	Same as above

POS

Line of Business

Description

Billing Guidance

Medicaid

Same as above

· AHCCCS is not utilizing POS 02 or 10 for its Telehealth approved codes.

· Effective 1/1/2022, AHCCCS requires that the POS billed on the claim be assigned based on the location of the member at the time of service.

Example:

If you complete an office visit via telehealth using interactive audio + video and the member was in their home at the time of the visit and the provider was in their office, you might bill:

Medicaid

Same as above

AHCCCS: For more information, please see:

Thank you for the excellent care you provide our members. If you have questions, please contact your Provider Engagement Specialist. If you need contact information for your assigned Provider Engagement Specialist, please email us at AzCHProviderEngagement@azcompletehealth.com.