Point32Health would like to remind providers of the required billing practices for telehealth services, which are documented on our Harvard Pilgrim and Tufts Health Plan Telehealth/Telemedicine Payment Policies and include variances by product.
In accordance with industry standard correct coding, when submitting a professional claim for services provided via telehealth, you’re required to use place of service (POS) code 02 (telehealth provided other than in patient’s home) or POS 10 (telehealth provided in patient’s home), as appropriate.
In conjunction with POS 02 or 10, you must also append one of the following modifiers (only these modifiers will be accepted for telehealth services) — depending on the member’s plan — and only one should be reported per line:
| Product/s | Required POS code (choose most appropriate) | Required modifiers (choose most appropriate) |
| Harvard Pilgrim Commercial, Tufts Health Plan Commercial, Tufts Health Direct, Tufts Health RITogether
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| Tufts Medicare Preferred HMO/PPO |
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| Tufts Health Plan Senior Care Options, Tufts Health Together, Tufts Health One Care |
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Please keep in mind that Point32Health will deny professional telehealth claims that do not include an appropriate modifier as identified above.
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