Revenue Cycle Insider

Question: Our provider, Dr. Thompson, completed a phone visit with an established patient for chronic disease management, medication refills, and disability form completion. The record indicates there were 85 minutes of discussion regarding the patient’s conditions and medication adjustments, as well as 30 minutes spent assisting the patient with the required paperwork.

Can the provider bill for the extra time they spent with the patient?

Washington Subscriber

Answer: No, because the maximum time you can bill for a telephone evaluation and management (E/M) visit is 40 minutes. You’ll assign 98015 (Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. When using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded.) to report the visit.

Make note: Even though the provider invested nearly two hours in the call, reimbursement does not extend beyond the first 40 minutes of covered service time, and completing paperwork is generally considered an administrative task, not to be counted toward an E/M service.

Lindsey Bush, BA, MA, CPC, Production Editor, AAPC