New telehealth codes for 2025 have an invalid status indicator from Medicare See the telemedicine section of CPT Coding Changes for 2025 for details. CPT® telephone codes 99441–99443 are deleted in the 2025 CPT book. Included in this article: Telehealth Update – March 19, 2025 Place of Service update from MLN Matters CPT® changes in […]
Interprofessional Internet Consultations
CMS recognizes and pays for six codes for interprofessional consults codes 99446–99449, 99451, 99452 See also HCPCS codes developed in 2025 for behavioral interprofessional consults | G0546–G0551 These codes were updated in 2023. Codes 99446, 99447, 99448, 99449 and 99451 may now be performed by physicians and other qualified health care professionals. Because these codes […]
CPT® Codes (99421-99423) – and Payment for – Online Digital Evaluation and Management (E/M) Services
Or, as I call them: message, manage, message. There are CPT codes for online digital E/M services. CPT developed a set of CPT® codes for use by physicians, physician assistants and advanced practice nurse practitioners performing brief, online E/M services via a secure platform There are also CPT® codes for use by clinicians who do […]
Does a Practitioner Need to Document Time for a Telehealth Visit?
Question: Does a practitioner need to document time for a telehealth visit? What if it is audio only? Answer: First: For a telehealth visit, always document if it is with video or audio only. Documenting “telehealth visit” or “telemedicine visit” doesn’t differentiate this. Second: If you are using office visit codes (99202—99215), you can select […]
When to Use CPT® Modifier -93
CodingIntel has a more complete article about modifiers 93 and 95, so be sure to read that. This is a brief Q&A, and doesn’t contain all you need to know. Modifier 95, 93: Telemedicine Question: In 2022, the question was, “should we begin using the new CPT® modifier -93?” Now, the question is, when should […]
Medicare “Audio-Only” Telehealth Services
This post discusses Medicare changes at the START of the PHE. It is for HISTORICAL REFERENCE ONLY. Some codes in this post have since been deleted. This note added 2/11/2025 CMS issued multiple waivers and two interim final rules to support health care organizations and patients during the public health emergency in spring 2020 Medicare […]
Coding Telehealth Visits: Place of Service
**Just a reminder, as of Jan 1, 2025 telehealth for Medicare is extended until March 31, 2025. Congress needs to act by then. Coding telehealth visits changes faster than the weather here in New England. The resources on the site relate to Medicare policy and CPT codes and rules. Unfortunately, they don’t address individual commercial […]
Is it or isn’t it a Telehealth Service?
Many payers and practices use the broad term telehealth to describe services that are not done face-to-face with a patient CMs describes telehealth services as non-face-to-face services that are on its telehealth list During the public health emergency, CMS eased the rules related to telehealth The flexibilities remain in effect for RHCs and FQHCs for […]
Specimen Collection For COVID-19
This post discusses Medicare changes at the START of the PHE. It is for HISTORICAL REFERENCE ONLY CMS’s 4/30/2020 rule states that practices could bill 99211 for new or established patients during the public health emergency for COVID-19 specimen collection CPT had previously recommended this The new HCPCS codes (G2023, G2024) for COVID-19 specimen collection […]
Medicare Changes Telehealth Rules, Again
This post discusses Medicare changes at the START of the PHE. It is for HISTORICAL REFERENCE ONLY. Some codes in this post have since been deleted. This note added 2/11/2025 Medicare changes telehealth rules, again: April 30, 2020 interim final rule with comment period (IFC) https://www.cms.gov/files/document/covid-final-ifc.pdf CMS released a second IFC with policy changes during […]
Modifier CS: Cost Sharing for COVID-19 Testing and Visits Related to Testing
This post discusses Medicare changes at the START of the PHE. It is for HISTORICAL REFERENCE ONLY. Effective retroactively to 3/18/20, there is no cost sharing allowed for COVID-19 testing or for the evaluation visits related to the testing Medicare instructs us to use modifier CS on the visits and tests, and to contact your […]
Payment for Telephone Calls During the PHE: CMS Rules for Phone Calls
Telephone codes 99441–99443 were deleted from the 2025 CPT book. This post discusses Medicare changes at the START of the PHE. It is for HISTORICAL REFERENCE ONLY. Some codes in this post have since been deleted. This note added 2/17/2025 CMS rules for phone calls has changed during the course of the pandemic. Prior to […]
Overview of Medicare Telehealth Services
Please see the Telemedicine article for the rules and guidelines for use during the COVID-19 public health emergency. Medicare covers some services performed via real-time audio and video between a patient in an underserved area and a physician or other practitioner who is not in the same place as the patient. Requirements for Medicare telehealth […]
Virtual Communication: HCPCS Codes G2010, G2250, G2251, G2252; CPT® 98016
Virtual communications are not considered telehealth These HCPCS codes were developed by CMS for virtual communication They are not on CMS’s list of telehealth services and do not use real-time, interactive, audio/visual communication They do require verbal consent; a single consent can be obtained for all communications based technology services annually for Medicare patients In […]
Modifier 95, 93: Telemedicine
CPT® has two modifiers for telemedicine. CMS and private payers regularly change their instructions about using these modifiers and what place of service to use. As of 2024, CMS no longer requires modifier 95 on claims but rather hopes to capture modality plus place of service by use of either POS 02 or POS 10.[1] (POS […]