mcolvin73
Guest
I have looked and have not a found a definitive answer. Can a copay be taken when a digital online e/m is billed ? Thank you
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- Thread starter mcolvin73
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TThivierge
True Blue
Hi Mcolvin
I believe you can bill copayment when online CPT codes used as long as documentation is presented. I estimate/guess fees run about 30 to 40 dollars for online CPT 99451 or 99421 .The online digital assessment are CPT 98972-98971 is sent. This is usually giving patient lab or xray lab results or assessing upcoming treatment for more care. However if established patient gave permission to obtain services by telehealth process ( video or phone call) it can be billed & copayment collected. If the patient came in for face to face treatment there be a charge unless global days was involved. Also if a charge is added to online CPT code plus documented why not bill ?
This is just my opinion but it seems logical, right?
Lady T
I believe you can bill copayment when online CPT codes used as long as documentation is presented. I estimate/guess fees run about 30 to 40 dollars for online CPT 99451 or 99421 .The online digital assessment are CPT 98972-98971 is sent. This is usually giving patient lab or xray lab results or assessing upcoming treatment for more care. However if established patient gave permission to obtain services by telehealth process ( video or phone call) it can be billed & copayment collected. If the patient came in for face to face treatment there be a charge unless global days was involved. Also if a charge is added to online CPT code plus documented why not bill ?
This is just my opinion but it seems logical, right?
Lady T
Last edited:
thomas7331
Guest
The patient’s insurance plan would determine whether or not the patient owes a copay for any given service, it isn’t up to the provider. You can collect a copay but if the plan pays the service in full, then you would need to refund it to the patient.
This.
There isn't a definitive one-size-fits-all answer, because it will depend on the patient's benefits.