Practice Management Alert

Reader Questions:

Consider This E/M Billing Loophole During PHE

Question: One of the people in my group practice is a clinical social worker and doesn’t usually bill their provided services via evaluation and management (E/M) codes. However, the social worker is interacting with patients remotely through virtual check-ins during the pandemic. Can we bill E/M codes here?

Mississippi Subscriber

Answer: Yes, during the public health emergency, says CMS in a frequently asked questions about Medicare fee for service (FFS) during COVID-19 document.

“During the PHE, the availability of HCPCS codes G2010 and G2012 is broadened to allow certain practitioners, such as physical therapists, occupational therapists, speech language pathologists, licensed clinical social workers, and clinical psychologists, who do not report E/M codes to bill for these services. CMS has also activated CPT® codes 98966, 98967, and 98968, which describe assessment and management services conducted over the phone,” CMS says.

Find more FAQs, updated July 2021, here