Optometry Coding & Billing Alert

Published on Thu Aug 22, 2013 PDF

Question: Another physician told my doctor that he’s receiving payment from his contractor for telephone calling codes. My doctor would like to start using these codes as well. Does Medicare pay for telephone calls?

New Hampshire Subscriber

Answer:  Medicare considers telephone call codes (99441-99443) to be non-covered services. You can find a code’s status in column D of the 2013 Medicare Physician Fee Schedule. For 99441-99443, CMS lists “N” in column D, which refers to “non-covered services.”

Silver lining: Your physician technically is getting paid for telephone calls made in relation to performed office visits. “The physician work resulting from telephone calls is considered to be an integral part of the pre-work and post-work of other physician services, and the fee schedule amount for the latter  services already includes payment for the telephone calls, “according to the Medicare Benefit Policy Manual, Chapter 15, Section 30 (Physician Services), Subsection B, Telephone Services (www.cms.gov/manuals/Downloads/bp102c15.pdf). The relative value units for office visits include typical times, such as 5-15 minutes depending on code level, for work that is spent before and after the visit on items like pulling the chart, reviewing lab results, and calling the patient. Since the fee schedule includes values for 99441-99443, some private payers may pay for the codes.