OTN – Telemedicine

How do physicians qualify for telemedicine?

To qualify physicians must sign and complete an “OHIP Telemedicine Physician Registration Form” to be registered as a telemedicine provider with the Ministry of Health and LongTerm Care.

How do I bill an OTN service?

First enter OTN in the SLI field.

The OTN Screening Service Codes (effective April 1, 2020):

B103A:
$0.00 Hosted video visit – patient attending at a patient host site
Synchronous video visits with a patient who is physically located and supported at a patient host site during the clinical encounter.

B203A:
$0.00 Direct-to-Patient Video Visit
Synchronous video visits with a patient in the home or another location of their choice (i.e. the patient is not at a patient host site).

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The OTN codes that were effective PRIOR to April 1, 2020

1. Premium Service Fee Codes that follow procedure service codes
   1. B100A: $35.00 First Telemedicine Patient Encounter premium (formerly OTN1)
   2. B200A: $15.00 Subsequent Telemedicine Patient Encounter premium (formerly OTN2)
2. Premium Fee Service Codes that are billed on their own
   1. B101A: $35.00 First Cancelled/Missed Telemedicine Patient Encounter premium*
   2. B201A: $15.00 Subsequent Missed/Cancelled Telemedicine Patient Encounter premium*
   3. B102A: $35.00 First Technical Difficulties Abandoned Patient Encounter premium*
   4. B202A: $15.00 Subsequent Technical Difficulties Abandoned Patient Encounter premium*

* Services cannot be billed in addition to the premiums for a missed, cancelled, or abandoned session.

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There are eleven Rejection codes applicable to telemedicine billings:

1. ET1: Provider Not Registered for Telemedicine Program;
2. ET4: Telemedicine Premium/Tracking Code Missing;
3. ET5: Telemedicine SLI Code Missing or Invalid;
4. TM1: Duplicate Telemedicine Claim for Same Patient;
5. TM2: Service Not Billable for Missed/Cancelled/Abandoned Appointment;
6. TM3: Service Not Payable Under Telemedicine Program;
7. TM4: Non-Telemedicine Claim Already Paid for This Patient;
8. TM5: Telemedicine Claim Already Paid for This Patient; and
9. TM6: Telemedicine Registration Not in Effect on Service Date.
10. TM7: Dental Services Not Payable Under Telemedicine Program;
11. TM8: Provider Not Eligible for Store Forward Telemedicine Services

For more information read bulletin 4750 here . . .