- General Information
- Originating Site
- Billing for Originating Site
- Facility Fee for Originating Site
- Distant Site
- Billing and Payment for Distant Site Professional Fee
- List of Covered Medicare Telehealth Services
- G0 Modifier Required for Telehealth for Individuals with Acute Stroke
- GT Modifier
- Clarification of Telehealth for DSMT
- ESRD-Related Services as a Telehealth Service
- Related Content
Originating Site
An originating site is the location of an eligible Medicare beneficiary at the time the telehealth services is being furnished via a telecommunications system. Medicare beneficiaries are eligible for telehealth services only when provided from an originating site located in a:
- rural HPSA located either outside of an MSA or in a rural census tract or
- county outside of a MSA.
The HRSA determine HPSAs and the U.S. Census Bureau determines MSAs. You can access HRSA’s Medicare Telehealth Payment Eligibility Analyzer to determine a potential originating site’s eligibility for Medicare telehealth payment.
Originating sites authorized by law are listed below:
- Office of a physician or practitioner
- Hospital (inpatient) – TOB 012X
- Hospital (outpatient) – TOB 013x
- CAH – TOB 012X; 085X
- RHC – TOB 071X
- FQHC – TOB 077X
- Hospital-based or CAH-based renal dialysis center/facility (including satellites) – TOB 072X
-
- Independent renal dialysis facility is not an eligible telehealth originating site
- SNF – TOB 22X or 23X
- CMHC – TOB 076X
- ESRD facility or the home of a Medicare beneficiary with ESRD when receiving home dialysis – refer to Note 1
- For purposes of furnishing the home-dialysis monthly ESRD-related clinical assessment
Note 1:
- Refer to CMS IOM Publication 100-04, Medicare Claims Processing Manual, Chapter 12, Section 190.3.4 – Payment for ESRD-Related Services as a Telehealth Service
- Expanded application of telehealth services is available only to physicians, providers and suppliers participating in the comprehensive ESRD care (CEC) model and providing telehealth services to Medicare ESRD beneficiaries associated with the CEC model. Please see MLN Matters® Article MM10314 Revised: Comprehensive ESRD Care (CED) Model Telehealth - Implementation for all billing requirements.
- Mobile stroke units – refer to note 2
- For purpose of diagnosis, evaluation, or treatment of symptoms of acute strike
Note 2:
- Geographic HPSA restrictions for approved originating sites now including mobile stroke units) have been removed. Please see MLN Matters® Article MM10883: New Modifier for Expanding the Use of Telehealth for Individuals with Stroke for specific billing guidelines.