CTP CTP Insurance Coverage and Reimbursement 1 — Questions and Answers
Question 1: Under CMS COVID-19 public health emergency waivers, which Medicare originating site restriction was temporarily lifted?
- Patients could receive telehealth services from their home (Correct answer)
- Services could only be delivered from rural health clinics
- Physicians were required to be physically present at the originating site
- Services were limited to mental health consultations only
Correct answer: Patients could receive telehealth services from their home
CMS PHE waivers allowed Medicare beneficiaries to receive telehealth services from their homes, eliminating the rural originating site requirement.
Question 2: Which modifier is used on Medicare claims to designate a service delivered via interactive audio and video telecommunications?
- Modifier 25
- Modifier 95
- Modifier GT (Correct answer)
- Modifier GQ
Correct answer: Modifier GT
Medicare requires Modifier GT on claims to indicate a service was provided via interactive audio and video telecommunications system for telehealth.
Question 3: Which federal law governs prescribing controlled substances via telehealth for patients the practitioner has never seen in person?
- HITECH Act
- Ryan Haight Online Pharmacy Consumer Protection Act (Correct answer)
- Telehealth Modernization Act
- MACRA
Correct answer: Ryan Haight Online Pharmacy Consumer Protection Act
The Ryan Haight Act requires an in-person evaluation before prescribing controlled substances via the internet, with exceptions during declared emergencies.
Question 4: Which telehealth modality involves capturing patient data and transmitting it asynchronously to a provider for later review?
- Live video psychiatric consultation
- Remote patient monitoring
- Store-and-forward (Correct answer)
- Audio-only telephone evaluation
Correct answer: Store-and-forward
Store-and-forward involves capturing and transmitting patient data such as images or records asynchronously to a provider who reviews it at a later time.
Question 5: Which place of service (POS) code specifically designates telehealth services provided to a patient at their home?
- POS 02
- POS 11
- POS 10 (Correct answer)
- POS 22
Correct answer: POS 10
CMS introduced POS 10 to designate telehealth services provided to a patient at their home, distinct from POS 02 used for telehealth at other locations.
Question 6: Which legislation expanded Medicare telehealth originating sites to include federally qualified health centers (FQHCs) and rural health clinics (RHCs)?
- ACA Section 3004
- Bipartisan Budget Act of 2018 (Correct answer)
- CHIPS Act
- HITECH Act
Correct answer: Bipartisan Budget Act of 2018
The Bipartisan Budget Act of 2018 added FQHCs and RHCs to the list of eligible Medicare telehealth originating sites.
CTP CTP Insurance Coverage and Reimbursement 1
Under CMS COVID-19 public health emergency waivers, which Medicare originating site restriction was temporarily lifted?