What you need to know about non face-to-face services
CMS has a stated goal of recognizing management services provided outside of an office visit. In particular, valuing and paying for care management and other non-face-to-face services.
Sometimes, this means recognizing existing CPT® codes, and changing the status indicator from bundled to active, so that it is a covered service. Sometimes, it means working with CPT®’s chronic care management committee to develop new codes that describe management services.
Although CMS is thinking about primary care, many of these codes can be billed by any specialty physician. Non-face-to-face prolonged services, which became a payable service in 2017 may be billed by any specialty physician/NP/PA.
Transitional care management may be billed by one physician/NP/PA who is providing the TCM services. (The surgeon may not bill during the global period.) Chronic care management may be billed by any specialty physician who is providing the service. The new collaboration of care for patients with behavioral health diagnoses is meant for primary care practices. (CoCM/BHI).
This guide also discusses the rules for home health certification. The payment isn’t high, but it is a service that is commonly performed.
Table of Contents
- Non face-to-face prolonged services – 99358, 99359
- Home health certification – G0180, G0179
- Transitional care management – 99495, 99496
- Chronic care management – 99487, 99489, 99490
- 99491 CCM by physician/NPP
- Collaboration of care/BHI – 99492, 99493, 99494, 99484
- Care management for behavioral health conditions
- Interprofessional consultations
- Remote monitoring
- Virtual communication – G2012, G2010
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Watch Betsy’s 60 minute on-demand webinar “Care Management in Primary Care Practices” for a review of the coding rules as well as tips for doing, and documenting care management services. Webinars are free for members. Not a member? Find out how you can watch too!
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