COVID-19 Outbreak: Using Telemedicine
Tuesday, March 10, 2020
Updated March 30, 2020
Coronavirus disease 2019, also referred to as COVID-19, is an emerging illness. While many details about the coronavirus are still unknown, we recognize the best way to prevent illness is to avoid exposing others to this virus. One option your office may be using to minimize patient and staff exposure during the COVID-19 outbreak is telemedicine. If you do offer this service, we’d like to remind you of TRICARE’s benefit and billing requirements.
TRICARE covers medically and psychologically necessary telemedicine services provided to a beneficiary at home. Specific technical requirements, outlined in TRICARE Policy Manual, Chapter 7, Section 22.1, must be met. (Note: Exclusions for applied behavior analysis services apply.) We offer an overview on our Telemedicine Services page. Audio-only telephone services are not covered.
How does state licensing apply to telemedicine?
Providers delivering telemedicine services must be licensed in the state(s) in which the services are provided and received. (For example, if the beneficiary’s home is in California but the provider is located in Washington, that provider must be licensed in California and Washington for the services to be covered by TRICARE.)
Is an authorization required?
Telemedicine services are subject to the same authorization and referral requirements that apply to in-person medical and psychological services. Visit our Prior Authorization, Referral and Benefit Tool to view current approval guidelines.
What video conference platforms can be used?
Video conferencing platforms must meet the requirements of the Health Insurance Portability and Accountability Act (HIPAA). Find additional details on video conferencing, connectivity and privacy guidelines on our Telemedicine Services page.
What is the difference between synchronous and asynchronous telemedicine services?
Synchronous telemedicine services refers to the exchange of electronic information in at least two directions at the same time, such as real-time video. Asynchronous telemedicine services refers to storing/transmitting information in one direction at a time, such as submitting medical history or images from one party to another.
How does billing work?
For synchronous telemedicine services, bill using CPT or HCPCS codes with a GT modifier for the distant site and Q3014 for the originating site to distinguish telemedicine services. Use place of service “02” in conjunction with the GT modifier. For asynchronous telemedicine services, bill using CPT or HCPCS codes with a GQ modifier and place of service “02.” Note: You may indicate "Signature not required – distance telemedicine site" in the required patient signature field on the claim form.
View the TRICARE Policy Manual, Chapter 7, Section 22.1 for additional information. For the latest information on the COVID-19 outbreak, visit www.cdc.gov/coronavirus.