PDF Version
TO: All
Providers
RE: BMI
Recording for Telemedicine Visits
The Alabama Medicaid Agency (Medicaid) is
implementing a Telemedicine Policy effective June 1,
2023. The Telemedicine Policy and detailed
information will be in Chapter 112 of
the July 2023 publication of the Provider Billing Manual. The
Telemedicine Policy is found at the following link:
https://medicaid.alabama.gov/documents/4.0_Programs/4.1_Covered_Services/4.1_Telemedicine_Policy_4-26-23.pdf
The BMI recording will continue to be
required for office visits including the telemedicine visits. The BMI is
required at least once per calendar year on all claims with procedure codes
99201-99205, 99211- 99215, and 99241-99245 and EPSDT procedure codes
99382-99385 and 99392-99395. To
be eligible for reimbursement for the telemedicine visits, the provider must
file the claim with the appropriate place of service and modifier GT for
audio and visual telecommunications or FQ for audio only
telecommunications.
During telemedicine visits, providers
should use subjective data to calculate the BMI which can include providers
asking the recipient for his or her height and weight during the visit. The BMI should be calculated, based on
the information provided by the recipient, and appended to the claim for
reimbursement. The BMI should also be documented in the recipient’s medical
record.
Note: Claims not billed correctly are
subject to post-payment review and recoupments.
Providers with
billing questions may visit www.medicaid.alabama.gov or contact the
Gainwell
Technology
Provider Assistance Center at 1-800-688-7989.
The Current Procedural Terminology (CPT) and Current Dental Terminology
(CDT) codes descriptors, and other data are copyright © 2022
American Medical Association and © 2022 American Dental Association (or such other date publication of CPT and
CDT). All rights reserved. Applicable FARS/DFARS apply.