Wiki • 98012 Synchronous audio-only visit

[Brenda1973]

As of 2025- If my telephone visit is 10 minutes is it unbillable? It has to be over 10 minutes, correct?
definition below:

• 98012 Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. When using total time on the date of the encounter for code selection, 10 minutes must be exceeded.

 

[dmartin@finrx.com]

Hi Brenda I have the same question. Page 17 of the CPT 2025 is confusing, It leads to the assumption that it is permissible to use 98016; but later goes on to state 98016 must be patient initiated

 

[Brenda1973]

Hi Brenda I have the same question. Page 17 of the CPT 2025 is confusing, It leads to the assumption that it is permissible to use 98016; but later goes on to state 98016 must be patient initiated

Right, we are not using 98016 at all because of patient initiated and to many other rules on that code. I have encountered many audio only visits that are documented "10 minutes on phone" so I am adjusting them off as non-billable as I believe the CPT reads audio needs to exceed 10 minutes. Hopefully someone on here can confirm.

 

[rhotonscott]

Right, we are not using 98016 at all because of patient initiated and to many other rules on that code. I have encountered many audio only visits that are documented "10 minutes on phone" so I am adjusting them off as non-billable as I believe the CPT reads audio needs to exceed 10 minutes. Hopefully someone on here can confirm.

Yes, the other synchronous audio-only codes require Greater than 10 minutes

 

[MKuil1]

Hi! Do we still add Mod 93 for 98012, and do we still use POS 02/10 for those visits? Thank you