Medicare telehealth place of service: 10 at home, 02 anywhere else

Code your patient's location, not yours. WPS, a Medicare contractor, wants modifier 95 only when you're in a hospital and your patient is at home.

Nate Peereboom
Co-founder, JotPsych

Your patient joins a video visit from work, and your claim says place of service (POS) 10, the code for home.

Medicare permanently lets your patients get mental health care by telehealth at home, wherever they live, a WPS educator says at 21:00.

1. Use POS 10 when your patient is at home. Home means a private residence, not a hospital or other facility. Medicare pays your telehealth visit with a patient at home at the non-facility rate of its fee schedule, per Medicare's telehealth booklet, page 9.
2. Use POS 02 when your patient is anywhere else. At work, your patient takes 02, the WPS educator says at 19:30. Don't assume home.
3. Don't code a home visit as telehealth. Seeing your patient in person at home isn't telehealth, because you're in the same place, the educator says at 12:30. Use POS 12, home, from Medicare's code list.
4. Add modifier 95 only if your contractor asks for it. WPS wants 95 on a professional claim only when the clinician is in a hospital and the patient is home (18:30). For professional claims, Medicare's telehealth booklet names POS 02 and 10, not modifier 95 (page 10). Outside WPS's six states, ask your own Medicare contractor.

Our view

Ask where your patient is at the start of every video visit. Write the answer in the note. The code on the claim then matches the note, so your biller doesn't have to guess and an auditor can see where your patient was during the visit.