CGS, a MAC servicing agencies in 15 states, has offered a clarification on telehealth codes expected on agency claims since July 1, 2023.
Agencies should not submit a telehealth service date as the location code (Q5001, Q5002, or Q5009) claim line-item date. Only an in person visit date may be reported with the location code, or the claim will return with reason code 31791.
As a reminder, the clarification reiterates that agencies shouldn’t submit a claim if only telehealth services and no in-person visits were provided in the billing period.