Receiving medical care from somewhere else is nowadays essential, and many patients choose to have in-home visits rather than traveling to the doctor. Virtual health visits are becoming more and more common, therefore it’s important for healthcare professionals to know how to bill appropriately and include the right modifiers on their claims. In particular, understanding how to apply the right CPT codes and modifiers is crucial for telemedicine practitioners to ensure correct reimbursement.

What’s Telemedicine?

The use of information technology to diagnose and treat patients remotely is known as telemedicine. There is no distinction between telemedicine and telehealth.

Common CPT Codes for Telemedicine:

When billing for virtual healthcare services delivered through voice, video, or other electronic communication channels, CPT codes for telemedicine are utilized. These codes allow medical professionals to correctly record and charge for telehealth visits. Guaranteeing that patients receive the appropriate compensation for services rendered remotely. Here are a few popular CPT codes for telemedicine along with their definitions:

Cheat Sheet of CPT Codes for Telehealth:

• Codes 99441–99443: These codes are used to bill for short-term digital assessment and management services provided online.
• Code 99441: 5–10 minutes of medical conversation over the phone with an E/M service.
• Code 99442: 11–20 minutes of medical conversation over the phone with an E/M service.
• Code 99443: Telephone E/M service for a 21–30 minute conversation about medicine.
• Codes 99421–99423: For established patients, the codes 99421–99423, which relate to online digital evaluation and management services, are applicable.
• Codes 99421: 5–10 minutes, up to 7 days.
• Code 99422: 11–20 minutes for 99422.
• Code 99423: 21 or more minutes are 99423.
• Codes 99201–992215: (E/M) Evaluation and Management CPT Codes are used for telehealth interactions. Relying on the complication and type of the communication. Office visits and other outpatient services, including those for both new and current patients, are covered by these codes.
• G2010: An established patient may submit pictures or video for remote review using this code.
• G2012: This code refers to virtual check-in services, which comprise quick examinations conducted by a healthcare professional using communication technology.

Audio-Only CPT Codes for Telehealth:

When it comes to billing and payment, audio-only telehealth which is especially helpful for patients with limited internet access or technological resources needs certain CPT codes. For audio-only telehealth, common CPT codes are;

• Codes 98966–98968: These codes, which span different time increments, are 98966–98968, and they are utilized for telephone evaluation and management services.
• Codes 99441–99443: These codes cover different time intervals and are mostly meant for digital evaluation. But they can also be used for telephone-based services for brief medical talks.
• Code G2012: This code is for virtual check-in services, which include quick assessments based on communication technology that are appropriate for one-on-one conversations.

CPT Codes for Inpatient Telehealth:

The use of telehealth in inpatient settings is growing as a means of enabling follow-up visits, remote consultations, and the delivery of specialty care. The following CPT codes are applicable to inpatient telehealth services:

• Codes 99451–99452: The inter professional telephone, internet, and electronic health record consultations that are given to inpatients are covered by these codes.
• Code 99451: Consultant reported using the internet, phone, and EHR to access data.
• Code 99452: Documented by the treating/requesting physician or QHP (primary care physician).
• Codes 99231-99233: Telehealth interactions pertaining to the administration of inpatient services and progress evaluation may utilize the following hospital care codes.
• Codes 99446–994449: These can be used for inpatient telehealth encounters to cover care coordination services, such as communication with other treating physicians or facilities. Conversations addressing different time intervals.

Telehealth places of service (POS) codes:

There are two places of service (POS) that are exclusive to telehealth:

• POS 02: When telehealth services are given somewhere other than the patient’s home, POS 02 is used.
• POS 10: When a patient receives telehealth services at home, POS 10 is used.

Also Read:

• Billing for E & M Codes
• Clinical Laboratory Billing
• Importance of Medical Billing Services for Ambulatory Surgery Centers

Modifiers for telehealth services:

Telehealth services may be supplemented with a number of modifications. Depending on the service type, the modifier could change.

• Modifier-95: Real-time interactive audio and video communications system for synchronous telemedicine services.
• Modifier-93: Real-time interactive audio-only telemedicine services provided synchronously over the phone or through another means of real-time communication.
• Modifier-GQ: Asynchronous telehealth services provided over a communications system.
• Modifier-GT: Telehealth services provided through interactive voice and video conferencing systems.
• Modifier-FQ: A telehealth service was provided through the use of audio-only real-time communication technology.

Conclusion:

The delivery of healthcare has been completely transformed by telehealth, which offers easy access to medical treatments from a distance. Healthcare practitioners and billing professionals need to be aware of the associated CPT codes due to the growing popularity of telemedicine. Working with The Medicator’s to outsource your telehealth coding can help you maximize revenue operations since our teams are always up to date on the most recent developments in telehealth billing and coding, which is crucial for correct invoicing and reimbursement.