Keeping track of telehealth reimbursem*nts 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 99202 – 99215 Office or other outpatient visits. New and established patients. G0425 – G0427 Consultations, emergency department, or initial inpatient. New and established patients. 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. 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. 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. 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. 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. - 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) In recent years, the Centers for Medicare & Medicaid Services (CMS) have released the physician fee schedule with expanded reimbursem*nt for remote patient monitoring (RPM). The guidelines notably increase reimbursem*nt for other services like remote therapeutic care and chronic care management, while making slight adjustments to allowances for RPM. Get My Free Guide The surge of telehealth adoption in recent years has led to regulatory changes and telemedicine coverage expansion that greatly benefits healthcare providers—if reimbursem*nt is done correctly. Here are the top four common mistakes when billing for telehealth, and how you can avoid them. 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 reimbursem*nt 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. 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. 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 reimbursem*nt. 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. CMS hasreleased its final rulefor Medicare payments under the Physician Fee Schedule (PFS), introducing significant changes that will impact healthcare providers across the country. To help you stay informed and prepared, we've compiled the eight key updates you need to know. View the 2024 updates At Health Recovery Solutions, we provide a host of resources on reimbursem*nt 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.Telehealth Visits Virtual Check-Ins Virtual Check-Ins (For providers who cannot independently bill for E/M services) Virtual Visit Telephone Services Interprofessional Telephone/Internet/Electronic Health Record Consultation Telemedicine Services CMS Telehealth & RPM Billing Guidelines [PDF]
Top 4 Common Telehealth Billing Mistakes—And How to Avoid Them
Mistake #1: Not keeping up with the correct billing codes
Mistake #2: Not maintaining post-visit documentation
Mistake #3: Not training your team on telehealth billing processes
Mistake #4: Not checking with the patient’s insurance beforehand
8 Key Updates to Telehealth Reimbursem*nt in 2024
Telehealth Reimbursem*nt Resources & Expert Support
2024 Telehealth CPT Codes: Cheat Sheet (2024)
Table of Contents
CMS Telehealth & RPM Billing Guidelines [PDF]
Top 4 Common Telehealth Billing Mistakes—And How to Avoid Them
Mistake #1: Not keeping up with the correct billing codes
Mistake #2: Not maintaining post-visit documentation
Mistake #3: Not training your team on telehealth billing processes
Mistake #4: Not checking with the patient’s insurance beforehand
Telehealth Reimbursem*nt Resources & Expert Support
References
References
- https://www.medicalbillgurus.com/cpt-code-list/
- https://codingmastery.com/2019/07/07/coding-complete-and-limited-emgs/
- https://www.aapc.com/blog/25658-procedure-coding-made-simple/
- https://www.carepatron.com/blog/a-guide-to-cpt-codes-and-how-to-use-them
- https://www.aapc.com/blog/84107-code-colonoscopies-with-precision/
- https://www.healthrecoverysolutions.com/blog/2024-telehealth-cpt-codes-cheat-sheet
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