What do I need to code to get paid for phone encounters?
No visual, only audio
No visual, only audio
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Phone encounters
- Thread starter kelly.kastler@yahoo.com
- Start date
Pam Warren
True Blue
There is no one answer to this. It depends on the circumstance, medical necessity, payer rules, intent of the call, and related services. There are codes for phone encounters only, but there are some rules about when you can bill them. Your question suggests that you may need to do some research. "How do I get paid" is not necessarily in line with correct coding, and as a certified coder you will want to ensure that you're coding and billing in a compliant manner so that when you do get paid, your practice is entitled to the money and you aren't going to have to worry about paying it back (or a patient being angry).
Starting on page 17 of AMA's 2026 CPT book is a great deal of information on telemedicine and when it's appropriate to report phone services. For example, you can't bill for a phone call when the patient doesn't request it (like to tell them about test results). You can't bill a phone service when there's an E&M that day. Some phone services that are related to Chronic Care Management services cannot be unbundled from that service. This is CPT's resource, but you also want to check CMS in terms of their telehealth (audio only) guidance, since there have been updates recently---and they don't necessarily follow CPT.
Starting on page 17 of AMA's 2026 CPT book is a great deal of information on telemedicine and when it's appropriate to report phone services. For example, you can't bill for a phone call when the patient doesn't request it (like to tell them about test results). You can't bill a phone service when there's an E&M that day. Some phone services that are related to Chronic Care Management services cannot be unbundled from that service. This is CPT's resource, but you also want to check CMS in terms of their telehealth (audio only) guidance, since there have been updates recently---and they don't necessarily follow CPT.