Medicare generally denies duplicate laboratory tests that are not medically necessary, so practices should review panel contents before ordering additional individual tests; when repeat testing is medically necessary, modifier 91 may apply. For telehealth services provided to patients in the Acute Hospital Care at Home program, Medicare considers the patient an inpatient, so providers should report POS 21 with modifier 95. CMS resources provide additional billing and coding guidance for both situations.
Resource: MLN Connects® Newsletter