Wiki 2025 Telem Visit

[KoBee]

We have a provider stating a 31 year old patient with Health Net called to have an office visit and chose to do audio only. Visit note supports all elements of an E/M except exam but he also documented a time of 5:38mins on the phone with patient.

There is no new 2025 telemed visit supporting less than 10 mins.

Would we still code for a level 2 even though it's a 15min time-based code and modifier 93?
or
Would we just determine visit per MDM and still apply modifier 93?

 

[coderfromtexas]

Could you use 98016?

 

[Brenda1973]

Audio only under 11 minutes is not billable per 2025 telemedicine guidelines


Telemedicine: Audio Only Established Patients• 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.• 98013 … low medical decision making … ; 20 minutes must be met or exceeded.• 98014 … moderate medical decision making … ; 30 minutes must be met or exceeded.• 98015 … high medical decision making … ; 40 minutes must be met or exceeded.