TELEHEALTH SERVICES
Beneficiaries can communicate with their doctors and certain practitioners without necessarily going to the doctor’s office in person for a full visit (i.e.,COVID-19)
These brief, “virtual check-in services” are for patients with an established relationship with a physician or certain practitioners where the communication is not related to a medical visit within the previous 7 days and does not lead to a medical visit within the next 24 hours (or soonest appointment available). The patient must verbally consent to using virtual check-ins and the consent must be documented in the medical record prior to the patient using the service. The Medicare coinsurance and deductible would apply to these services.
TELEHEALTH SERVICES ARE SCHEDULED TO END 12/31/2024
- Allows telehealth services furnished in any geographic area and in any originating site setting, including beneficiary’s home
- Allows services to be furnished via audio-only telecommunications systems
- Allows physical therapists (PTs), occupational therapists (OTs), speech-language pathologists (SLPs) and audiologists to furnish telehealth services
G2010 Remote evaluation of recorded video and/or images submitted by an established patient (i.e., store and forward), including interpretation and follow-up with the patient within 24 business hours, not originating from a related E/M service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment
G2012 Brief communication technology-based service (i.e., virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related E/M service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion
Online digital evaluation and management services are patient-initiated services with physicians and other qualified health care professionals. These services require physician or other qualified health care professionals evaluation, assessment and management of the patient. These services are not for the nonevaluative electronic communication of test results, scheduling of appointments or other communication that does not include E/M.
99421 Online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 5-10 minutes
99422 11-20 minutes
99423 21 or more minutes
Telephone services are non-face-to-face evaluation and management services provided to a patient using the telephone by a physician or other qualified health care professional, who may report evaluation and management services. These codes are used to report episodes of patient care initiated by an established patient or guardian of an established patient. If the telephone service ends with a decision to see the patient within 24 hours or ext available urgent visit appointment, the code is not reported, rather the encounter is considered part of the preservice work of the subsequent service.
99441 Telephone evaluation and management service by a physician or other qualified health care professional who may report evaluation and management services provided to an established patient, parent or guardian not originating from a related E/M service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion
99442 11-20 minutes
99443 21-30 minutes
98966 Telephone evaluation and management service by a qualified nonphysician health care professional provided to an established patient, parent or guardian not originating from a related E/M service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion
98967 11-20 minutes
98968 21-30 minutes
Interprofessional consultations
99446 Interprofessional telephone/internet/electronic health record assessment and management service provided by a consultative physician or other qualified health care professional, including a verbal and written report in the patient’s treating/requesting physician or other qualified health care professional; 5-10 minutes of medical consultative discussion and review
99447 11-20 minutes
99448 21-30 minutes
99449 31 minutes or more
99451 Interprofessional telephone/internet/electronic health record assessment and management service provided by a consultative physician or other qualified health care professional including a written report to the patient’s treating/requesting physician or other qualified health care professional, 5 minutes or more of medical consultative time
- Can be reported for new or established patients and/or problem
- Cannot be reported more than once per seven days for the same patient
- Are only reported by a consultant when requested by another physician
- Are reported based on cumulative time spent, even if that time occurs on subsequent days
- Are not reported if a transfer of care or request for a face-to-face consult occurs as a result of the consultation within the next 14 days
- Are not reported if the patient was seen by the consultant within the past 14 days
- Require the request and the reason for the request for the consult be documented in the record
- Require verbal consent for the interprofessional consultation from the patient/family documented in the patient’s medical record
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