Wiki G2010 and G2012

G2010 is for the provider to use if/when the patient sends a video or still picture to the physician for evaluation, it states the provider must in addition have a 5-10 minute discussion with the patient after the evaluation of the submitted images.
G2012 is for the patient to check in with the provider to access Whether the patient requires a face to face encounter. One suggestion is it could be used as part of a treatment regimen for opioid use disorders and other substance use disorders to assess whether the patient’s condition requires an office visit. This can be either a phone encounter or if it meets the requirements a telehealth encounter.
If either of these results in a visit then they are not billable.
 
G2010 is for the provider to use if/when the patient sends a video or still picture to the physician for evaluation, it states the provider must in addition have a 5-10 minute discussion with the patient after the evaluation of the submitted images.
G2012 is for the patient to check in with the provider to access Whether the patient requires a face to face encounter. One suggestion is it could be used as part of a treatment regimen for opioid use disorders and other substance use disorders to assess whether the patient’s condition requires an office visit. This can be either a phone encounter or if it meets the requirements a telehealth encounter.
If either of these results in a visit then they are not billable.

Hi Debra,

Where are you finding that the provider must have a 5-10 minute discussion with the patient for G2010? I cannot find this reference. It is my understanding that the follow-up take place via phone call, audio/video communication, secure text messaging, email, or patient portal communication. (HIPAA compliant).

Thank you!
Jenny
 
yes I am sorry if that was not clear, I stated a 5-10 minute discussion after the evaluation of the image(s), as in a follow up. In what form that discussion takes place is not clear but it is considered to be a part of the G2010
 
How does G2012 differ from 99441? I'm finding both listed for some state Medicaid telehealth programs. My previous belief was that G2012 was patient-initiated and 99441 wasn't, but saw elsewhere on this forum that 99441-99443 is strictly for patient-initiated visits as well. Why would a payer put both of these options on their fee schedule for telehealth visits? See Ohio Mcd: http://www.registerofohio.state.oh.us/pdfs/5160/0/1/5160-1-21_PH_EM_NE_APP1_20200320_1032.pdf
 
All of the telehealth codes are for patient initiated contacts. If can fulfill the exam elements, you may even use some of the 99xxx E/M codes. While the regulations state these visits have to be for established patients only, under new emergency guidelines for the Corona emergency, they may also be used for new patients. Also, to bill the 99xxx or the 9942x codes, you have to communicate with the patient over a synchronous video platform. Normally, the platform has to be HIPAA compliant. However, again due to emergency regulations, you may use a non HIPAA complaint platform, such as FaceTime or Skype, but you should put a note in the patient file that you notified them that the communication was happening over a non HIPAA compliant platform and that the patient gave verbal consent for that.

The patient also has to give verbal consent for you to bill their health insurance for the telehealth visit.

Tom Cheezum, OD, CPC, COPC
 
Ok, I'm super confused now. Just starting to do telehealth by our pcp's via telephone. I was under the impression I use G2012. Now I'm wondering (just for patient initiated telephone "visits") do I use G2012 or 99441-99443? Or just like a 99212 (regular E/M) visit only via telephone???
 
Here's a brief summary. If you use G2012, it may be done just through a phone conversation with the patient.
Medicare doesn't pay for 99441-43.
Medicare will pay for 99421-23. However, those telemedicine must be done using a real time video conference platform. Under normal circumstances, you have to use a HIPAA compliant platform such as doxy.me. However, with emergency orders now in place for the corona emergency, you may use a non HIPAA compliant communication platform such as Skype or FaceTime.
You may also use 99212 code when using a real time platform like Skype.
Usually, you can only use these codes for established patients. However, under the emergency orders, you may also use the 99202 for a new patient. OIG has said it will not enforce the established patient only requirement for this service.
 
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Here's a brief summary. If you use G2012, it may be done just through a phone conversation with the patient.
Medicare doesn't pay for 99441-43.
Medicare will pay for 99421-23. However, those televisions must be done using a real time video conference platform. Under normal circumstances, you have to use a HIPAA compliant platform such as doxy.me. However, with emergency orders now in place for the corona emergency, you may use a non HIPAA compliant communication platform such as Skype or FaceTime.
You may also use 99212 code when using a real time platform like Skype.
Usually, you can only use these codes for established patients. However, under the emergency orders, you may also use the 99202 for a new patient. OIG has said it will not enforce the established patient only requirement for this service.
Thank you!!
 
The digital visit (99421-99423) does not need to be completed via synchronous (real time digital conference platform) communication. It can be completed via email, EHR patient portal, or other HIPAA compliant software. As long as the patient is communicating digitally with the provider, it qualifies. If synchronous technology is being used (right now Skype, FaceTime, and Duo have been approved by CMS), it would be best to use the standard set of E/M's (99201-99214) with POS 02.
 
Ok, so if it's phone call only can I use G2012 &/or G2010 in addition to the phone call? (99441-43.
To show that the pt. checked in via portal & physician pulled up chart & viewed photo of pt. while on phone call?
 
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