Wiki Telephone Calls

[erica.schwalm@hfcca.com]

Hello,

First post!

I recently started at a Cardiology practice and found that we do not currently have the technology to offer audiovideo options for telehealth.

What, if any, options do providers have to bill for phone calls with patients who are elderly & unable to come in.

Only thing I have come up with is 98016, which is practically a freebie. Or start doing home visits. Or update your computers. Haha

IF by chance, the elderly patient has a cell phone and knows how to video, could the provider use their personal cell phone to conduct a visit?

Thank you,
Erica

 

[jkyles]

Hi there.
1. For Medicare patients, none. However, some private payers are accepting the audio-only codes.
2. 98016 is for established patients, the call has to be initiated by the patient and has some other limits (see the CPT manual for details). You should report it when appropriate, but make sure it's appropriate.
3. Probably not. Your practice must use a HIPAA-secure platform to perform the encounter and I've never heard of that sort of software being available for phones. But if there's a way to run that through a cellphone, your provider is willing to pay for the software (and the provider believes an A/V encounter is appropriate, etc), I'd say go for it.

 

[rachaelwilleford]

In order to bill audio only for Medicare, the provider must have audio-video telecommunications ability. The reason for audio-only is supposed to be documented, for example if the patient does not have the ability or knowledge to do audio-video. It was in the Physician Fee Schedule Final Rule for 2025.

 

[jkyles]

That's for mental/behavioral health treatments.