Telehealth Service

Beneficiariescan communicate with their doctors and certain practitioners withoutnecessarily going to the doctor’s office in person for a full visit (i.e.,
COVID-19)

Thesebrief, “virtual check-in services” are for patients with an establishedrelationship with a physician or certain practitioners where the communicationis not related to a medical visit within the previous 7 days and does not leadto a medical visit within the next 24 hours (or soonest appointment available). The patient must verbally consent to using virtual check-ins and theconsent must be documented in the medical record prior to the patient using theservice.  The Medicare coinsurance anddeductible would apply to these services.

TELEHEALTHSERVICES ARE SCHEDULED TO END 12/31/2024

·        Allows telehealth services furnished in anygeographic area and in any originating site setting, including beneficiary’shome

·        Allows services to be furnished via audio-onlytelecommunications systems

·        Allows physical therapists (PTs), occupational therapists(OTs), speech-language pathologists (SLPs) and audiologists to furnishtelehealth services

G2010            Remote evaluation of recorded videoand/or images submitted by an established patient (i.e., store and forward),including interpretation and follow-up with the patient within 24 businesshours, not originating from a related E/M service provided within the previous7 days nor leading to an E/M service or procedure within the next 24 hours orsoonest available appointment

G2012            Brief communication technology-basedservice (i.e., virtual check-in, by a physician or other qualified health careprofessional who can report evaluation and management services, provided to anestablished patient, not originating from a related E/M service provided withinthe previous 7 days nor leading to an E/M service or procedure within the next24 hours or soonest available appointment; 5-10 minutes of medical discussion

Onlinedigital evaluation and management services are patient-initiated services withphysicians and other qualified health care professionals.  These services require physician or otherqualified health care professionals evaluation, assessment and management ofthe patient.  These services are not forthe nonevaluative electronic communication of test results, scheduling ofappointments or other communication that does not include E/M.

99421             Online digital evaluation andmanagement service, for an established patient, for up to 7 days, cumulativetime during the 7 days; 5-10 minutes

99422                         11-20 minutes

99423                         21 or more minutes

Telephoneservices are non-face-to-face evaluation and management services provided to apatient using the telephone by a physician or other qualified health careprofessional, who may report evaluation and management services.  These codes are used to report episodes ofpatient care initiated by an established patient or guardian of an establishedpatient.  If the telephone service endswith a decision to see the patient within 24 hours or ext available urgentvisit appointment, the code is not reported, rather the encounter is consideredpart of the preservice work of the subsequent service.

99441             Telephone evaluation and managementservice by a physician or other qualified health care professional who mayreport evaluation and management services provided to an established patient,parent or guardian not originating from a related E/M service provided withinthe previous 7 days nor leading to an E/M service or procedure within the next24 hours or soonest available appointment; 5-10 minutes of medical discussion

99442                         11-20 minutes

99443                         21-30 minutes

98966             Telephone evaluation and managementservice by a qualified nonphysician health care professional provided to anestablished patient, parent or guardian not originating from a related E/Mservice provided within the previous 7 days nor leading to an E/M service orprocedure within the next 24 hours or soonest available appointment; 5-10minutes of medical discussion

98967                         11-20 minutes

98968                         21-30 minutes

Interprofessionalconsultations

99446             Interprofessionaltelephone/internet/electronic health record assessment and management serviceprovided by a consultative physician or other qualified health careprofessional, including a verbal and written report in the patient’streating/requesting physician or other qualified health care professional; 5-10minutes of medical consultative discussion and review

99447                         11-20minutes

99448                         21-30minutes

99449                         31minutes or more

99451             Interprofessional telephone/internet/electronichealth record assessment and management service provided by a consultativephysician or other qualified health care professional including a writtenreport to the patient’s treating/requesting physician or other qualified healthcare professional, 5 minutes or more of medical consultative time

·        Can be reported for new or established patientsand/or problem

·        Cannot be reported more than once per seven daysfor the same patient

·        Are only reported by a consultant when requestedby another physician

·        Are reported based on cumulative time spent, evenif that time occurs on subsequent days

·        Are not reported if a transfer of care or requestfor a face-to-face consult occurs as a result of the consultation within thenext 14 days

·        Are not reported if the patient was seen by theconsultant within the past 14 days

·        Require the request and the reason for the requestfor the consult be documented in the record

·        Require verbal consent for the interprofessionalconsultation from the patient/family documented in the patient’s medical record

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