Telemedicine for providers

 

Important information

During this stateside public health emergency, there are no copays or cost-shares for telemedicine care and audio only telemedicine visits are covered.

TRICARE policy requires providers to have a license in the state where they practice and where the patient lives, but TRICARE will temporarily reimburse providers for interstate care to patients. The care must be permitted by federal or state licensing laws and the provider must not be affirmatively barred or restricted from practicing in any state.

Covered telemedicine services

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).

View our telemedicine FAQs for providers

Billing information

Synchronous telemedicine services

These services involve an interactive, electronic information exchange in at least two directions in the same time period. 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.

IMPORTANT: Place of Service “POS 02” is to be reported in conjunction with the GT modifier.

Asynchronous telemedicine services

These services involve storing, forwarding and transmitting medical information on telemedicine encounters in one direction at a time. Providers billing for asynchronous telemedicine services will use CPT or HCPCS codes with a GQ modifier.

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 TRICARE Policy Manual, Chapter 7, Section 22.1.