BILLABLE VIRTUAL SERVICES
Physicians are connecting to patients utilizing telecommunication technology in office, hospital, and several other in-person care settings. This includes live audio-video and real-time audio/telephone communications. There have been significant expansions in coverage from both CMS and commercial payers to make sure providers are adequately compensated during this public health emergency (PHE).
CPT CODES FOR CALLS WITH A DOCTOR OR MIDLEVEL PRACTITIONER
Codes that refer to phone conversations are billed by duration of call, not level of care:
- 99441 phone call 5 to 10 minutes of medical discussion
- 99442 phone call 11 to 20 minutes
- 99443 phone call 21 to 30 minutes
CPT CODES FOR CALLS WITH A QUALIFIED NON-PHYSICIAN HEALTH CARE PROFESSIONAL
Codes for phone conversations with non-physician health care professionals:
- 98966 phone call 5 to 10 minutes of medical discussion
- 98967 phone call 11 to 20 minutes
- 98968 phone call 21 to 30 minutes
CPT CODES FOR AUDIO-VISUAL
Live audio-video visits between providers and patients offer greater reimbursement than audio alone. These visits should be billed using set evaluation and management codes with the correct place of service being where care would have been delivered in-person and modifier GT or 95.
WHAT IS NECESSARY FOR BILLING?
In addition to call duration, physicians must obtain and document patient consent for a virtual visit. Some facilities are relying on e-signatures via email or in-person signatures in anticipation of future telehealth visits. Clinicians may also have the ability to receive consent via their telehealth platforms. It is recommended to make note of this consent in patient medical records and to ensure that the patient initiates the call.
SELECTING A TELEHEALTH VENDOR
Some of the important points to consider when choosing a telehealth vendor include:
- The platform’s ability to integrate with your current system of record keeping;
- The ease of usability for clinicians and patients;
- The level of customer service support available for troubleshooting;
- And all security and safety measures taken.
Particular scrutiny over telehealth vendor security standards is necessary for a medical provider or
facility to fully measure risk/liability.
AS A REMINDER
Please note certain specialties (RHC, DME, autism care, PT, labs, chiropractors, etc.) have some differences with CPT codes. In every case, it is important to provide all pertinent information to your billers at Express Medical Billing to ensure expedient and accurate submission of telehealth charges.