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Elizabeth M. Whitehorn, Director

Expansion of Telehealth Services – Payment of the Q3014

HFS System Issue:

Expansion of Telehealth Services – Payment of the Q3014 Telehealth Originating Site Fee to Community Mental Health Providers for SASS eligible participants

Problem:

Telehealth Originating Site Facility Fee (Procedure Code Q3014) is billable by community mental health providers when a distant site physician service is rendered via telehealth to a Medicaid eligible participant per the 01/12/10 provider notice Expansion of Telehealth Services. Claims for Q3014 from community mental health providers for SASS eligible participants may have been inadvertently underpaid, due to logic that was tied to the payment of the distant site service.

Providers Impacted:

Community Mental Health Providers

Procedure Codes Impacted:

Q3014 – Telehealth Originating Site Facility Fee

Problem Begin Date:

Claims received January 29, 2010

Problem Fix Date:

March 25, 2014

Resolution for Impacted Claims:

Claims for dates of service within timely filing limits may be re-billed. If claims were underpaid (state max amount for Q3014 is $25.00), replacement claims (bill type ‘7’) may be submitted electronically if within one year from the original voucher date. Claims that were underpaid but are over one year from original voucher date will need to be voided by submitting a paper form (HFS 2262) and then re-billed on an original, paper claim form (HFS 1443) and mailed with a request for time override to: HFS, P.O. Box 19115, Springfield, IL 62794, once the voided claim has been processed.