tch678
New
I can't find any guidelines for New Patient telehealth visits. Does Medicare and Commercial Insurances cover them? I thought at one point when the pandemic ended in 2023 that they quit covering them.
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Wiki Televisits for New Patients
- Thread starter tch678
- Start date
TThivierge
True Blue
Tch678
I think most payers cover it now. But minutes must be noted in documentation and type of visit audio or telehealth plus ID verified mention in note of patient. It states that new or est pt with audio or telehealth use the following CPT per time. Each set goes up to 60 minutes..I ll let you look up rest of CPT codes
New Pt telehealth 15 minutes 98000 New pt Audio 15 mins 98008
New Pt telehealth 30 minutes98001 New Pt Audio 30 mins98009
Est Pt telehealth 15 minutes 98004 Est Pt Audio 15 mins 98012
Est pt telehealth 30 minutes 98005 Est Pt Audio 30 minutes 98013
No longer use 99202-99214 and add modifier 93 or 95 if telehealth.
Hope it helps!
Lady T
I think most payers cover it now. But minutes must be noted in documentation and type of visit audio or telehealth plus ID verified mention in note of patient. It states that new or est pt with audio or telehealth use the following CPT per time. Each set goes up to 60 minutes..I ll let you look up rest of CPT codes
New Pt telehealth 15 minutes 98000 New pt Audio 15 mins 98008
New Pt telehealth 30 minutes98001 New Pt Audio 30 mins98009
Est Pt telehealth 15 minutes 98004 Est Pt Audio 15 mins 98012
Est pt telehealth 30 minutes 98005 Est Pt Audio 30 minutes 98013
No longer use 99202-99214 and add modifier 93 or 95 if telehealth.
Hope it helps!
Lady T
apoland
Networker
As of Oct 1, 2025 the COVID telehealth flexibilities were set to end. This excludes treatment of certain chronic conditions and behavioral health. There may be some leeway with the government shut down?? Each payer will have their own policy of course. CMS does not accept the audio only codes.
https://www.cms.gov/files/document/telehealth-faq-updated-10-15-2025.pdf
https://www.cms.gov/files/document/telehealth-faq-updated-10-15-2025.pdf
jkyles
True Blue
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Medicare never covered the new telemedicine codes except the virtual check-in code (98016). You'll need to check with your MAC to see how it is handling telehealth services. For coverage of the new telehealth codes by commercial payers you'll have to look at each policy. The last time I checked they were all over the place.