by Aimee L. Wilcox, CPMA, CCS-P, CST, MA, MT
Jun 13th, 2019
Medicare's 2019 Final Rule approved HCPCS code G2010 for reimbursement, which allows providers to be paid for remote evaluation of images or recorded video submitted to the provider (also known as "store and forward") to establish whether or not a visit is required. This allows providers to get paid for services they typically perform and which promote quality patient care that they otherwise wouldn't have been paid for in the past.
In order for G2010 to be considered a reimbursable service it must meet the following requirements:
- The patient is an established patient
- The provider is contracted with Medicare and eligible (based on credentialing and licensure) to perform Evaluation and Management (E/M) services
- Medical necessity for the service must be apparent in the documentation
- Consent must be obtained from the patient after ensuring they understand it is a billable service that will be applied towards their annual deductible and co-insurance and they will be responsible for those portions of the service.
- The service may not be separately billable if it:
- is related to an E/M encounter that occurred within 7 days prior, in which case it is bundled into that E/M service
- results in the patient being scheduled for an E/M encounter within 24 hours (or soonest available)
Documentation Requirements
The importance of clear and concise documentation cannot be overstated. When documenting the service, or reviewing it for coding and auditing purposes, be sure it contains the following:
- Provider's notes regarding the telecommunication service including findings, impression, and plan of action
- Clearly-identifiable medical necessity for the service
- Consent for the service (patient was made aware of applicable deductible and co-insurance)
- A copy of the image or video submitted for review (accessible and part of the permanent medical record)
G2010 Remote evaluation of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related E/M service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment