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 | ||
|
99202 – 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)
CMS Telehealth & RPM Billing Guidelines [PDF]
In recent years, the Centers for Medicare & Medicaid Services (CMS) have released the physician fee schedule with expanded reimbursement for remote patient monitoring (RPM). The guidelines notably increase reimbursement for other services like remote therapeutic care and chronic care management, while making slight adjustments to allowances for RPM.
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.
Telehealth Reimbursement Resources & Expert Support
At Health Recovery Solutions, we provide 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. Whether you're in the early stages of researching the benefits of telehealth and remote patient monitoring for your patients or you have an existing program in place and you're considering options to maximize the value of RPM, our team of experts is here to support you.
