Wiki Telehealth Scenario - Video to phone

[kstine713]

Hello,

Do you know how our providers would code if they are attempting a virtual video visit, but technology fails (video freezing, poor connection, etc.) and the provider has to finish the visit via telephone? I have communicated that the provider would have to use the phone codes at that point, but our providers are saying they heard that as long as you have attempted the video call, you can still bill like it was a virtual visit even if you finish by phone only. Any links you have are super appreciated!

Thank you!

 

[bscanlon]

I would like an answer to the above question as well. We are running into this same situation

 

[csperoni]

There were several posts about this within the past 2 years. The CMS guidance was if the majority of the visit was able to be completed via video, code 99202-99215. If the video never connected, then code as telephone 99441-99443. The note should indicate the exact situation that occurred.
From https://www.cms.gov/files/document/medicare-telehealth-frequently-asked-questions-faqs-31720.pdf (page 75 Question 26)
26. Question: If the video connection is disconnected during an audio-video Medicare telehealth visit due to technological issues, can the visit still be billed as Medicare telehealth?
Answer: Practitioners should report the code that best describes the service. If the service was furnished primarily through an audio-only connection, practitioners should consider whether the telephone evaluation and management or assessment and management codes best describe the service, or whether the service is best described by one of the behavioral health and education codes for which we have waived the video requirement during the PHE for the COVID-19 pandemic. If the service was furnished primarily using audio-video technology, then the practitioner should bill the appropriate code from the Medicare telehealth list that describes the service. Note that CPT codes 99441–99443, which describe audio-only telephone E/M phone visits with practitioners who can independently bill for E/M services, have been added to the Medicare telehealth list for the purposes of the PHE for the COVID-19 pandemic, and payment rates for these codes are set to be the same as the analogous in-person E/M visits.