Full-service revenue cycle management for phycisian practices and hospitals

The Centers for Medicare and Medicaid Services (CMS) has provided clarification for the “Telehealth Visits using Audio/Visual” versus “Telephone Only”.  The Medicare fee schedule has been updated to reflect the new policies.  Below is the updated list of Telehealth visit codes and the Medicare Allowable amounts.

Additionally, Medicare has added 80 codes that can be performed with Telehealth Audio/Visual visits. Please check the complete list of Telehealth procedures.

Standard E&M Services

  • 99201-99205 – Office/Outpatient New patient visits.
  • 99211-99215 – Office/Outpatient Established patient visits.
  • 99217-99220 – Initial observation and discharge.
  • 99224-99226 – Subsequent observation codes.
  • 99234-99236 – Observation/discharge same day.
  • 99221-99223 – Initial hospital care.
  • 99231-99233 – Subsequent hospital visits.
  • 99238-99239 – Hospital discharge.
  • G0406-G0408 – Follow-up inpatient consultation.
  • 99281-99285 – Emergency department visits.
  • 99291-99292 – Critical care services.
  • 99304-99306 – Initial nursing facility visits.
  • 99307-99310 – Subsequent nursing facility visits.
  • 99315-99316 – Nursing facility discharge.
  • 99327-99328 – Domiciliary, rest home, or custodial care services, new patient.
  • 99334-99337 – Domiciliary, rest home, or custodial care services, established patient.
  • 99341-99345 – Home visits, new patient.
  • 99347-99350 – Home visits, established patient.
  • 99354-99355 – Prolonged Service – Office and Outpatient.
  • 99356-99357 – Prolonged Service – Inpatient.
  • 99441-99443 – Telephone evaluation and management service.
  • G0425-G0427 – Telehealth consultation, emergency department or initial inpatient communicating with the patient via telehealth.
  • G0459 – Inpatient telehealth pharmacologic management, including prescription, use, and review of medication with minimal medical psychotherapy.
  • G0508-G0509 – Telehealth consultation, critical care Annual Wellness and Preventive Medicine.
  • G0438-G0439 – Annual wellness visits.
  • G0513-G0514 – Prolonged preventive services.
  • G0447 – Obesity counseling, 15 minutes.
  • G0444 – Annual depression screening, 15 minutes.
  • 99406-99407 – Smoking cessation services.
  • G0436-G0437 – Tobacco-use counseling.
  • G0442 – Annual alcohol misuse screening, 15 minutes.
  • G0443 – Brief face-to-face behavioral counseling for alcohol misuse, 15 minutes.
  • G0396-G0397 – Alcohol and/or substance abuse structured assessment and brief intervention.
  • 99497-99498 – Advanced care planning, 30 minutes.
  • G0445 – Sexual behavior counseling, semi-annually, 30 minutes.
  • G0446 – Cardiovascular behavior therapy, 15 minutes.
  • G0296 – Lung cancer screening.

Other services

  • 99495-99496 – Transitional care management.
  • G0506 – Chronic care management assessment.
  • 97802-97804 – Medical nutrition therapy.
  • G0108-G0109 – Individual and group diabetes self-management training services, with a minimum of 1 hour of in-person instruction to be furnished in the initial year training period to ensure effective injection training.
  • G0270 – Individual and group medical nutrition therapy.
  • 96160-96161 – Health risk assessment.
  • G2086-G2088 – Office-based treatment for opioid use disorder.
ESRD Services
  • 90951-90970 ESRD.
  • G0420-G0421 Individual and group kidney disease education services.
Psychotherapy Services
  • 90785 Interactive complexity psychiatry services.
  • 90791-90792 Psychiatric diagnostic interview examination.
  • 90832-90838 Individual psychotherapy.
  • 90839-90840 Psychotherapy for the crisis.
  • 90845 Psychoanalysis.
  • 90846-90847 Family psychotherapy.
  • 90853 Group psychotherapy.
  • 96116 Neurobehavioral status examination.
  • 96130-96139 Psychological and neuropsychology testing.
  • 96150-96154 Individual and group health and behavior assessment and intervention.
  • 96156 Health behavior assessment.
  • 96160-96161 Health risk assessment.
  • 96167-96168 Health behavior intervention.
Therapy services
  • 97161-97168 Evaluations.
  • 97110, 97112, 97116, 97535, 97750, 97755, 97760, 97761, 92521-92524, 92507.
Radiation treatment management
  • 77427 Radiation treatment management, 5 treatments.

– List of Telehealth Visits services updated 4.5.2020

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Finally, when you know the right people are handling your revenue cycle, you can relax and focus on what you do best- delivering excellent medical care.

PRM is here to help make life easier for you and your office staff. Join our medical billing company today and enjoy our benefits! Contact Us

Lanny Menendez
Professional Reimbursement Managers