Keeping track of telehealth reimbursements accurately directly impacts your healthcare organization’s bottom line. We’ve compiled a list of telehealth CPT codes to help you better navigate telehealth billing for your care program.

 

Remote Patient Monitoring CPT Codes

 
  Telehealth Visits  

99201 – 99215

Office or other outpatient visits.

New and established patients.

G0425 – G0427

Consultations, emergency department, or initial inpatient.

New and established patients.

  Virtual Check-Ins  

G2010

Remote evaluation of recorded video and/or images submitted by an established patient (for example, store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related E/M service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment.

Established patient.

G2012

Brief communication technology-based service by a physician or other qualified health care professional who can report evaluation and management services, not originating from a related E/M service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion.

Established patient.

G2252

Brief communication technology-based service by a physician or other qualified health care professional who can report evaluation and management services, not originating from a related E/M service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment; 11-20 minutes of medical discussion.

Established patient.

  Virtual Check-Ins (For providers who cannot independently bill for E/M services)  

G2250

Remote assessment of recorded video and/or images submitted by an established patient (for example, store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related service provided within the previous 7 days nor leading to a service or procedure within the next 24 hours or soonest available appointment.

Established patient.

G2251

Brief communication technology-based service by a qualified health care professional who cannot report evaluation and management services, not originating from a related E/M service provided within the previous 7 days nor leading to a service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion.

Established patient.

  Virtual Visit  

99421 –99423

Online digital evaluation and management service, for up to 7 days, a cumulative time during the 7 days.

Established patient.

G2061 – G2063

Online assessment by qualified non-physician healthcare professional.

Established patient.

  Telephone Services  

99441 –99443

Evaluation and management by a physician or other qualified health care professional who may report evaluation and management services provided to a patient, parent, or guardian not originating from a related E/M service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment.

Established patient.

  Interprofessional Telephone/Internet/Electronic Health Record Consultation  

99446 – 99449

Assessment and management service provided by a consultative physician, including a verbal and written report to the patient’s treating/requesting physician or other qualified health care professional.

*Each code includes time for medical consultative discussion and review

-

99451

Assessment and management service provided by a consultative physician, including a written report to the patient’s treating/requesting physician or other qualified health care professional, 5 minutes or more of medical consultative time.

-

99452

Referral service(s) provided by a treating/ requesting physician or other qualified health care professional, 30 minutes.

-

  Telemedicine Services  

G0406-G0408

Follow-up inpatient consultation via telehealth.

Established patient.

G0425-G0427

Telehealth consultation, emergency department.

New patient.

G0508, G0509

Telehealth consultation, critical care.

New and established patients.

Source: American Academy of Sleep Medicine (AASM)

Top 4 Common Telehealth Billing Mistakes—And How to Avoid Them

The surge of telehealth adoption in recent years has led to regulatory changes and telemedicine coverage expansion that greatly benefits healthcare providers—if reimbursement is done correctly. Here are the top four common mistakes when billing for telehealth, and how you can avoid them.

Mistake #1: Not keeping up with the correct billing codes

As Medicare regulations change in response to public healthcare needs, the billing codes that you’re already familiar with could change as well. Submitting claims with the wrong code could result in delayed reimbursement and in some worst cases, be flagged for abuse.

Avoid by: Staying up to date with additions or deletions to the list of Medicare telehealth services.

Mistake #2: Not maintaining post-visit documentation

Ensuring that you document the right information during telehealth visits is key to getting prompt payment. For a start, touch base with your administrative team to understand the type of information you should be keeping a record of.

Avoid by: Creating a checklist that you can go over before the telehealth visit for cross-checking purposes.

Mistake #3: Not training your team on telehealth billing processes

Your team already has to keep track of thousands of CPT codes on a daily basis. With the new batch of telehealth CPT codes added to the mix, things can easily get very complicated for your team.

Avoid by: Training your team on the types of codes, processes, and all things reimbursement.

Mistake #4: Not checking with the patient’s insurance beforehand

While most major private payers provide coverage for telemedicine, it’s prudent to call up the payer and confirm if the services offered are covered. The good news is, that you’ll only need to verify this once for that particular policy.

Avoid by: Being more diligent about checking insurance coverage before the patient’s first telehealth visit. Use an insurance verification form to log the call and make sure you’re asking the right questions.

Learn More About Telehealth Reimbursement with an Expert Today

We have a host of resources on reimbursement and telehealth billing modeled after best practices that we established from working with our healthcare partners—and we’re ready to help.

Request a Demo with Our Reimbursement Specialists