Telephone Billing Telemedicine

cwilson3333

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Having trouble understanding how to bill telephone calls under telemedicine/telehealth coding.

G2012 [POS?]

CPT 99441 {POS?}

For instance, if the doctors places a call to a patient, to go over Test results from MRI, Cat Scan, etc.

Or when patient calls for new complaint, and doctor returns phone call.
 

csperoni

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The telephone encounter must be patient initiated. So in your first example, provider calls patient to discuss test results, that is not billable.
If the patient calls provider office with a complaint, and physician returns the call, that is billable with either G2012 or 99441-99443. Medicare covering 99441-99443 is a very new policy, and historically only covered G2012. Basically, the difference right now (for Medicare) between G2012 and 99441 which both specify 5-10 minutes is that G2012 may only be for established patients, while 99441 had the restriction lifted and may be billed for new or established.
The above is the CMS policy. Private carriers have differing guidance and policies about billing telephone encounters.
POS for telephone encounters is 11.
 

jhendrix08

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The telephone encounter must be patient initiated. So in your first example, provider calls patient to discuss test results, that is not billable.
If the patient calls provider office with a complaint, and physician returns the call, that is billable with either G2012 or 99441-99443. Medicare covering 99441-99443 is a very new policy, and historically only covered G2012. Basically, the difference right now (for Medicare) between G2012 and 99441 which both specify 5-10 minutes is that G2012 may only be for established patients, while 99441 had the restriction lifted and may be billed for new or established.
The above is the CMS policy. Private carriers have differing guidance and policies about billing telephone encounters.
POS for telephone encounters is 11.
Christine,
Your post is really helpful. I just posted this question in the forum but I'm hoping you can help. Do you know what Medicare will reimburse for 99441-99443? I can't find it anywhere. Thanks in advance!
 

csperoni

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Per Supercoder, the national reimbursement is below. Keep in mind your area's conversion factor could change the exact rate.
G2012 $14.80
99441 $14.44
99442 $28.15
99443 $41.14
 

jhendrix08

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Per Supercoder, the national reimbursement is below. Keep in mind your area's conversion factor could change the exact rate.
G2012 $14.80
99441 $14.44
99442 $28.15
99443 $41.14
I'm so grateful for your help. Thank you so much for taking the time to get this info for me.
 
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Same. I had a physician query me, asking if she should be including the medical assistants phone time with the patient, in the total time spent, when billing. This would be a phone visit, no video. The MA would be asking check-in assessment questions-I believe screening questions such as if they have a fever, shortness of breath, recent travel. Going over the description of the Telephone Services CPT codes, it states that it would be furnished by a physician or other qualified health a professional, so I take that as only counting the phone time with the doctor. I can’t find any resources on clarifying this, am I interpreting that correctly?
 
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