Billing for Audio-only Telehealth

1. Billing for Audio-only Telehealth The Centers for Medicare & Medicaid Services (CMS) made many changes to adapt patient care amid the COVID-19 pandemic. Expanding Medicare coverage to include a range of services through audio-only telehealth visits is one of them. Let’s understand some of the basic coding guidelines for audio-only telephone visits: CPT Code 99441-99443 Code Description 99441: Telephone evaluation and management service by a physician or other qualified health care professional who may report evaluation and management services provided to an established 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; 5-10 minutes of medical discussion. 99442: 11-20 minutes of medical discussion 99443: 21-30 minutes of medical discussion www.medicalbillersandcoders.com Copyright ©-2020 MBC. All Rights Reserved Call now 888-357-3226 (Toll Free) info@medicalbillersandcoders.com 1

2. Basic Guidelines for 99441-99443 Physicians, nurse practitioners, clinical nurse specialists, certified nurse-midwives and physician assistants use these CPT codes. Audio-only telephone visits were previously had a status indicator as non-covered services but now CMS will pay for phone calls using codes 99441-99443. In most of the cases for 99441-99443, the place of service would be office (11) or outpatient department (19, 22). You have to add modifier 95 since they are now telehealth services Telephone codes 99441–99443 require audio only but will pay at the rates of 99212–99214 Non-facility payment Facility payment CPT Code 99212 $ 46.13 $ 26.31 99213 $ 76.04 $ 52.26 99214 $ 110.28 $ 80.37 CPT Code 98966-98968 Other qualified health care professionals who may bill Medicare for their services, such as registered dietitians, social workers, speech-language pathologists, and physical and occupational therapists should use codes 98966-98968. CPT Code Non-facility payment 98966 $13.32 98967 $26.64 98968 $39.60 www.medicalbillersandcoders.com Copyright ©-2020 MBC. All Rights Reserved Call now 888-357-3226 (Toll Free) info@medicalbillersandcoders.com 2

3. Code Description 98966: Telephone evaluation and management service by a qualified non-physician health care professional to an established patient, parent, or guardian not originating from a related assessment and management service provided within the previous 7 days nor leading to an evaluation and management service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion. 98967: Telephone call 11-20 minutes 98968: Telephone call 21-30 minutes About Medical Billers and Coders We are catering to more than 40 specialties, Medical Billers and Coders (MBC) is proficient in handling services that range from revenue cycle management to ICD-10 testing solutions. The main goal of our organization is to assist physicians looking for billers and coders. www.medicalbillersandcoders.com Copyright ©-2020 MBC. All Rights Reserved Call now 888-357-3226 (Toll Free) info@medicalbillersandcoders.com 3