TELEMEDICINE RULES – MICHIGAN HEALTHCARE SERVICES RULES 02-01-19

TELEMEDICINE RULES – MICHIGAN HEALTHCARE SERVICES RULES 02-01-19

R 418.10109 Definitions; M to U.

Rule 109. As used in these rules:

(x) “Telemedicine” means the use of an electronic media to link patients with health care

professionals in different locations. To be considered telemedicine, the health care professional must be able to examine the patient via a real-time, interactive audio and video telecommunications system, and the patient must be able to interact with the off-site health care professional at the time the services are provided.

R 418.10901 General information.

Rule 901.

(4) A health care professional billing for telemedicine services shall only utilize procedure codes listed in Appendix P of the CPT codebook, as adopted by reference in R 418.10107, to describe services provided, excluding CPT codes 99241-99245 and 99251-99255. The provider shall append modifier -95 to the procedure code to indicate synchronous telemedicine services rendered via a real-time interactive audio and video telecommunications system with place of service code -02. All other applicable modifiers shall be appended in addition to modifier -95.

R 418.101004 Modifier code reimbursement.

Rule 1004.(14) When modifier -95 is used with a procedure code listed in Appendix P of the CPTcodebook, as adopted by reference in R 418.10107, excluding CPT codes 99241-99245 and99251-99255, the telemedicine services shall be reimbursed according to all of the following:

(a) The carrier shall reimburse the procedure code at the non-facility maximum allowablepayment, or the billed charge, whichever is less.

(b) Supplies and costs for the telemedicine data collection, storage, or transmission shall notbe unbundled and reimbursed separately.

(c) Originating site facility fees shall not be separately reimbursed.