99441-99443 Non-Face-to-Face Telephone Services
Telephone services are non-face-to-face evaluation and management (E/M) services provided to a patient using the telephone by a
physician or other qualified health care professional, who may report evaluation and management services.
Physician or other qualified healthcare professionals must have a State license, education/training showing qualifications, as well as facility privileges.
Examples of other qualified healthcare professionals:
- Nurse Practitioner (NP)
- Certified Nurse Specialist (CNS)
- Physician Assistant (PA)
- Certified Nurse Midwife (CNM)
- Certified Registered Nurse Anesthetist (CRNA)
(NOTE: this list is not all-inclusive, please refer to your payer with more specific questions)
These codes are used to report episodes of patient care initiated by an established patient or guardian of an established patient. If the telephone service ends with a decision to see the patient within 24 hours or next available urgent visit appointment, the code is not reported; rather the encounter is considered part of the preservice work of the subsequent E/M service, procedure, and visit.
Likewise, if the telephone call refers to an E/M service performed and reported by that individual within the previous seven days (either requested or unsolicited patient follow-up) or within the postoperative period of the previously completed procedure, then the service(s) is considered part of that previous E/M service or procedure.
(Do not report
99441-
99443, if
99421,
99422,
99423 have been reported by the same provider in the previous seven days for the same problem.)
(For telephone services provided by a qualified non-physician who may not report evaluation and management services [
eg, speech-language pathologists, physical therapists, occupational therapists, social workers, dietitians), see
98966-
98968)