Wiki TELEMEDICINE VS. PHONE APPT

bill2doc

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Hi All,

Are any of you billing for telemedicine? If so, can you share what we need to know? CPT codes used? Does telemedicine mean on a video device vs. phone appt which is on the phone? Any clarification would be appreciated!!
 
Telemedicine includes video/Zoom and telephone (99441-99443). a phone visit should have a time statement, either start/stop or total time spent.
The virtual visit/Zoom will be billed with regular E/M codes with a 95 modifier.
The type of visit is determined when appt is made-Telephone or Virtual. The guidelines for billing vary extensively per payor. Some want you to crosswalk your telephone visit to regular E/M with modifier during the pandemic, some don't.
 
Telemedicine includes video/Zoom and telephone (99441-99443). a phone visit should have a time statement, either start/stop or total time spent.
The virtual visit/Zoom will be billed with regular E/M codes with a 95 modifier.
The type of visit is determined when appt is made-Telephone or Virtual. The guidelines for billing vary extensively per payor. Some want you to crosswalk your telephone visit to regular E/M with modifier during the pandemic, some don't.
Could we use prolonged services code G2212 or 99417 with 99441 - 99443?
 
Could we use prolonged services code G2212 or 99417 with 99441 - 99443?
You cannot bill prolonged services on telephone visits, for video (telehealth) you may depending on the payor and how they want the claim billed. Each payor has a policy on how to bill both telephone and telehealth visits including POS and modifiers needed for billing. We created a spreadsheet for the payors we bill and the dates they changed policies to make it easier for us.
 
You cannot bill prolonged services on telephone visits, for video (telehealth) you may depending on the payor and how they want the claim billed. Each payor has a policy on how to bill both telephone and telehealth visits including POS and modifiers needed for billing. We created a spreadsheet for the payors we bill and the dates they changed policies to make it easier for us.
I came across 99354 and 99355 as an addition code, if required for 99441-99443 telephone visit codes.
 
I came across 99354 and 99355 as an addition code, if required for 99441-99443 telephone visit codes.
This is incorrect - per the 'code first' note in CPT, these codes may only be used in addition to 99241-99245, 99324-99337, 99341-99350, 90837, 90847.

I agree with the post above that you cannot bill prolonged time for the telephone service codes, unless a payer has a policy specifically allowing it.
 
Telephone 99441-99443 do not have prolonged service codes, per the correct responses by @jmph0916 and @thomas7331.

From CMS FAQs, section P, question 32:
Question: How should practitioners bill for audio-only services that last longer than 30 minutes?
Answer: During the PHE for the COVID-19 pandemic, Medicare has added to the list of telehealth services CPT codes 99441–99443, which describe audio-only phone visits with practitioners who can independently bill for E/M services, and CPT codes 98966–98968, which describe audio-only phone visits with practitioners who cannot independently bill for E/M services (for example certain therapists, social workers, and clinical psychologists). CPT codes 99443 and 98968 describe 21–30 minutes of medical discussion, respectively for each practitioner type; but there are no CPT codes available to describe medical discussions lasting longer than 30 minutes.
New: 5/27/2020

It is possible a commercial carrier has set a different policy, but I have not seen any.
 
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