Wiki Legality of charging for Patient Portal

Melissasuewashburn

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The way that our EHR is set up the Patient Portal is a subscription based service that has an annual fee attached to it. One of our physicians is stating that as of October that it is illegal to charge patients for a patient portal, however I cannot find any documentation on this. Is anyone else aware of this and if so have a direction they can point me so that I can make sure our practice has the correct information?
 
I'm not understanding your question.

what would you be billing your patients for?

there are plenty of benefits to using a patient portal, for both patients and providers, and you can bill for telehealth services that are provided through a patient portal.
but just "charging patients for a patient portal", doesn't make sense to me.
 
What specifically is the patient portal subscription meant to cover?

I am also a little confused. Typically patient portals are free to the patient to view appointments, visit history, etc.

However, perhaps I'm not understanding what services you're providing through the portal that would necessitate charging the patient.
 
The way that our EHR is set up the Patient Portal is a subscription based service that has an annual fee attached to it. One of our physicians is stating that as of October that it is illegal to charge patients for a patient portal, however I cannot find any documentation on this. Is anyone else aware of this and if so have a direction they can point me so that I can make sure our practice has the correct information?
If I'm understanding your question, you are saying that you have been charging patients a "fee" to access their records and appointments on the patient portal for your practice ? I believe that the portal is typically an add-on service provided by the EHR companies, but I have never heard of the provider passing on this fee to their patients, in any form. Legal or not, I dont think that is a good idea.
 
I agree with the other replies that it's just not a good idea to charge patients for that service - it's considered a part of the practice's overhead and shouldn't be separately itemized to the patient. As to the legality of it, this isn't the right place to be seeking or giving that kind of advice - speak to an attorney in your state who is familiar with state and local laws and can give you current information. Laws governing business practices vary from one state to another, and we coders here aren't attorneys and aren't qualified to give you that kind of information.
 
Can anyone provide guidance as to where I can find the CPT code identified to bill for patient portal messaging?

The Current Procedural Terminology, or CPT, codes released that year gave providers a way to bill for patient portal messages, according to a January 2020 American Medical Association article.

Providers can bill for cumulative work done over a seven-day period that takes five minutes or more, according to the AMA report. Time worked can't be counted twice or billed under a separate code. The clock on the seven days starts ticking with the review of the patient's inquiry and can include an examination of the patient's medical record, the development of a management plan, the generation of a prescription or test order, and any subsequent online communication.
 
They might be talking about 99421-99423

I agree.

Make sure you understand the guidelines before you report them because they're very specific. Billing for the services will add another wrinkle to charging patients to use the portal because the patient would have a copay for the encounter on top of the subscription fee.

(Also, I'm curious about what happens if the patient says no to the subscription fee.)
 
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