Telehealth revolutionized mental health care, but billing it incorrectly costs psychiatric practices thousands of dollars in lost "non-facility" revenue every month.
POS 10: The Patient is at Home
If your patient is sitting in their living room, bedroom, or a hotel while you conduct the therapy session via Zoom, you must use Place of Service (POS) 10. This tells Medicare the patient is at home, and crucially, allows you to be paid at the higher "non-facility" rate.
POS 02: The Patient is Elsewhere
If your patient is physically located at a hospital, skilled nursing facility, or another clinic during your telepsychiatry call, you must use POS 02. Medicare pays this at the lower "facility" rate because the facility is bearing the overhead cost.
Audio-Only Exceptions
Mental health is one of the few specialties where Medicare has permanently expanded audio-only access (Modifier 93). If the patient refuses or cannot use video, document the reason, use the standard therapy codes, and append the appropriate audio-only modifiers based on your payer matrix.
NCCI Edits
Ensure your modifiers (95 for video, 93 for audio) correctly align with your Place of Service. Conflicting telehealth indicators are a leading cause of automated clearinghouse rejections.