There are a number of sites you can go to get advice on operating your practice during the COVID pandemic, such as the CDC and the AMA. Unfortunately, many practices are still struggling with their financial health during the crisis.
The pandemic has created a tremendous need for telehealth services. Most physicians believe that telemedicine requires full audio and video over a computer interface. But many patients lack reliable internet access. As a result, CMS and other insurers have approved the use of a telephone call for many of telehealth services.
Telephone-only evaluation and management (E/M) codes exist for patient-initiated calls and telephone consultations. There are codes for both qualified E/M providers and medical assistants. These codes generally conform to a specific block of time spent on behalf of the patient. They are blocked in 5 - 10, 11 - 20, and 21+ minute increments. Each of the codes has some specific requirements.
Let’s start with the simplest one, 99421-3. This code is labeled online digital E/M. It was designed for use by physicians, physician assistants and nurse practitioners performing brief online services via a secure platform. This includes telephone calls on a HIPAA-secure recorded line. Verbal consent must be given by the patient.
The 99421-3 codes can only be used for existing patients. They can be billed for up to seven days of cumulative time. This includes time to review the record or data pertinent to the assessment of the patient’s problem or concern. The codes are for services that would have been done face-to-face, such as discussion of laboratory results or renewal of prescriptions. These services can be reported once during every seven day timeframe. These services are meant to be brief and their reimbursement is in the $15-$50 range.
A similar set of codes exist for non-E/M qualified providers to perform online digital professional assessment. These codes are G2061-3. As with the 99421-3 codes, they can be billed for up to seven days of cumulative time. As with 99421-3, they can be reported once every seven days. The reimbursement is in the $12-$33 range.
Among the best of the telehealth CPT codes are 99441-3. This group of CPT codes was initially designed for telephone consultations. They were previously non-covered. A ruling on April 30, 2020 added these codes to the telehealth list and increased the payments for services. Verbal consent must be given by the patient. These codes require audio only. They are reimbursable at rates comparable to those of regular office visits, 99212-4, in the range of $46-$110.
These services are designated for a physician or other qualified E/M healthcare provider. They cannot be utilized if the patient was seen within the previous seven days. Similarly, they cannot be utilized if they result in a visit within the next 24 hours or soonest available appointment.
MedXCom provides a way to perform these services over a HIPAA-secure recorded telephone line. This creates a legal record of the conversation which can be accessed by the practice at any time in the future. The recording is stored for 23 years. MedXCom is now able to provide billing information to the practice on your telehealth services. We feel this is the best way to take advantage of these new codes and support your practices during the time of COVID.
For more tips on using telehealth, check out the "Complete Guide to Telehealth."