As Part B News has reported on its blog, CMS and other divisions of the Department of Health and Human Services have launched a massive drive to make telehealth accessible to practices and patients.
Here’s a quick summary of E/M-related changes that will take effect March 31 and will run for the duration of the current COVID-19 emergency.
Code office E/M via telehealth based on time or MDM
Get a preview of how you’ll code office visits next year when you report telehealth office visits. The interim rule will allow practices to use the current medical decision-making or typical times to select a code for a telehealth visit during the emergency. However, time is “defined as all of the time associated with the E/M on the day of the encounter,” which
echoes next year’s standards.
“This policy only applies to office/outpatient visits furnished via Medicare telehealth, and only during the [public health emergency] for the COVID-19 pandemic,” the rule states.
Report telephone E/M visits
When a phone conversation with a patient goes beyond a virtual check-in as described by HCPCS code G2012, you’ll be able to turn to the time-based phone codes in your CPT manual, the interim rule states. Physicians and qualified health care professionals who can report E/M services may use the following codes:
- 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).
When the service is performed by a qualified health care professional who can’t bill for E/M services, such as a licensed clinical social worker or a physical therapist, turn to the medicine codes, which will be listed as sometimes therapy codes to facilitate billing by physical therapists:
- 98966 (Telephone assessment and management service provided by a qualified nonphysician 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 assessment and management service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion).
- 98967 ( …; 11-20 minutes of medical discussion).
- 98968 ( …; 21-30 minutes of medical discussion).
You can ignore the restriction to established patients in the descriptors. CMS is “exercising enforcement discretion on an interim basis to relax enforcement of this aspect of the code descriptors,” the rule states.
This is a breaking news story. Please check back for additional updates.