November 12, 2019

Telemedicine

TRICARE covers the use of interactive audio/video technology to provide clinical consultations and office visits when appropriate and medically necessary. These services are subject to the same referral and authorization requirements and include, but are not limited to:

• Clinical consultation
• Office visits
• Telemental health (individual psychotherapy, psychiatric diagnostic interview examination and medication management)

Providers delivering telemedicine services must be licensed in the state(s) where the services are provided and received. Video conferencing platforms used for telemedicine services must have the appropriate verification, confidentiality and security parameters necessary to meet the requirements of the Health Insurance Portability and Accountability Act (HIPAA).

Billing information

Providers billing for:

• synchronous* telemedicine services will use CPT or HCPCS codes with a GT modifier for distant site and Q3014 for an applicable originating site to distinguish telemedicine services. Also, Place of Service “POS 02” is to be reported in conjunction with the GT modifier.
• asynchronous* telemedicine services will use CPT or HCPCS codes with a GQ modifier.

*Synchronous telemedicine services involve an interactive, electronic information exchange in at least two directions in the same time period. Asynchronous telemedicine services involve storing, forwarding and transmitting medical information on telemedicine encounters in one direction at a time.

When submitting claims for telemedicine services, the provider may indicate "Signature not required – distance telemedicine site" in the required patient signature field.

For more information on providing telemedicine services, see the TRICARE Policy Manual, Chapter 7, Section 22.1