Telehealth without the patient present


If a provider performs a telehealth visit (audio/visual) for a pediatric patient, but only the mom was present during the service, may we bill the E/M?


Telehealth has certainly changed the landscape in the past year.  Think of telehealth as a delivery mechanism.  If the clinician were to see mom for an appointment in the clinic without the child, it would not be a billable E/M for the patient. The same would apply for a telehealth visit; the face-to-face expectations are the same, it’s just the “delivery mechanism” that has changed. Reporting a service as an E/M without the patient present represents audit risk. A reasonable expectation would be to have the child present for at least a portion of the visit.  You could take this one step further and check with your top payers (always a best practice).