A Medical consultant (other than a radiologist) may claim the appropriate consultation health service code with modifier TELES when a patient is referred from another physician, audiologist, a midwife, chiropractor, podiatrist, dentist, optometrist, physical therapist or nurse practitioner.
Referrals from a non-physician other than an audiologist, midwife, chiropractor, podiatrist, dentist, optometrist, physical therapist or nurse practitioner may be claimed under the appropriate non-referred visit health service code.
A Podiatric Surgeon consultant may claim the appropriate consultation health service code with modifier TELES when a patient is referred from a Medical practitioner, podiatric surgeon or a podiatrist. Referrals from any other source may be claimed under the appropriate non-referred visit health service code.
Please refer to Governing Rules 17.1, 17.5, and 17.6 for more information.