Updates to telemedicine Place of Service (POS) and modifier

June 24, 2022

TRICARE updated its telemedicine Place of Service (POS) codes for dates of service on or after Jan 1, 2022, and included adding POS 10 to the telehealth codes.

  • POS telehealth codes
    • POS 02 – Telehealth provided other than in patient’s home: Healthcare services delivered through video conferencing technology in a setting outside of the beneficiary’s home
    • POS 10 – Telehealth provided in patient’s home: Healthcare services delivered through videoconferencing technology in the beneficiary’s home
  • Telehealth and TRICARE
    • The use of secure video conferencing to deliver medically and psychologically necessary services to beneficiaries is covered by TRICARE. Providers should use one of the appropriate telehealth modifiers (95, GT or GQ) when billing POS 02 or POS 10. For more information on coverage and requirements, refer to TRICARE Policy Manual, Chapter 7, Section 22.1.

For more information on CMS POS codes, visit CMS.gov

October 18, 2021

When billing for synchronous telemedicine/telehealth services, providers will use CPT or Healthcare Common Procedure Coding System (HCPCS) codes with a GT or 95 modifier for distant site and Q3014 for originating site to distinguish telemedicine/telehealth services. In addition, POS 02 code may be reported in conjunction with GT or 95 modifier. However, POS 02 is not required to be reported through the end of the COVID-19 pandemic if a more appropriate code is necessary for correct billing, include POS code equal to what it would have been had the service been furnished in person. By coding and billing the GT or 95 modifier with a covered telehealth procedure code, the distant site provider certifies that the beneficiary was present at an eligible originating site when the telehealth service was furnished.

For billing asynchronous telemedicine/telehealth services, providers will use CPT or HCPCS codes with a GQ modifier. In addition, POS 02 may be reported in conjunction with the GQ modifier. However, POS 02 is not required to be reported through the end of the COVID-19 pandemic for telehealth claims if a more appropriate POS code is necessary for correct billing, include POS code equal to what it would have been had the service been furnished in person.

See TRICARE Policy Manual, Chapter 17, Section 22.1, 2.3.2 for more information.