New CPT Codes for Digital Therapies and Telemedicine
June 29, 2022Physicians can now administer safe treatments to non-COVID and COVID patients using telemedicine. Also, it enables small health care practices to remain in business and even extend the services they offer.
With this new technology, patients can easily schedule appointments, view their medication histories, and communicate with their doctors. Telemedicine will continue to enhance remote health care for many years to come.
Meanwhile, accurately tracking telehealth reimbursements can directly impact the bottom line of your health care practice. Our new list of CPT codes for digital therapies and telemedicine helps you facilitate better management of telehealth billing.
CPT Codes for Telemedicine/Telehealth
The following codes are commonly reported for Medicare patients:
| CPT Codes for Telehealth Visits | Description of Service |
| 99201-99205 | Office/outpatient evaluation and management (E/M) visit, new |
| G0425 – G0427 | Consultations, emergency department, or initial inpatient (Medicare only) |
| Virtual Visit/Check-Ins CPT Codes | Description of Service |
| CPT Code G2010 | Remote evaluation of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, 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. |
| CPT Code G2012 | Brief communication technology-based service, e.g., virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related E/M service provided within the previous seven 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. |
In addition, the Centers for Medicare & Medicaid Services (CMS) created two additional G codes for billing by practitioners who cannot independently bill for E/M services. G2250 and G2251 are CPT codes billable by a selected group of nonphysician practitioners based on their benefit categories.
| HCPCS G Code | Description of Service |
| G2250 | Remote assessment of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related service provided within the previous seven days nor leading to a service or procedure within the next 24 hours or soonest available appointment. |
| G2251 | Brief communication technology-based service, e.g., virtual check-in, by a qualified health care professional who cannot report evaluation and management services, provided to an established patient, not originating from a related E/M service provided within the previous seven days nor leading to a service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion. |
| G2252 (CMS permanently establishes separate coding and payment for the extended virtual check-in service, G2252, effective January 1, 2022.) The reimbursement amount has been cross-walked to the reimbursement for Current Procedural Terminology (CPT) code 99442. | Brief communication technology-based service, e.g., virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related E/M service provided within the previous seven days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment; 11-20 minutes of medical discussion. |
Telephone Evaluation & Management (E/M) Services
CPT codes for telephone E/M are time-based. In addition, payments for telephone E/M services CPT codes 99441-99443 are equivalent to 99212-99214 and can be used for new or established patients during the Public Health Emergency (PHE). Modifier 95 should be applied, and the place of service (POS) should be where the visit would have taken place in person before the public health emergency (e.g., 11-Office, 22-Hospital Outpatient, 23-ASC). Before reporting codes for non-Medicare beneficiaries, ensure that your commercial payers cover these services.
| CPT Code 99441 | For any new or established patients, telephone or audio-only evaluation and management services cannot originate from a related E/M service provided within the previous seven days nor lead to an E/M service or procedure within the next 24 hours or as soon as the earliest available appointment, 5-10 minutes of medical discussion. |
| CPT Code 99442 | 11-20 minutes of medical discussion |
| CPT Code 99443 | 21-30 minutes of medical discussion |
| E-Visits | Description of Service |
| 99421 – 99423 | Online digital evaluation and management service, for an established patient, for up to 7 days, a cumulative time during the 7 days |
| G2061 – G2063 | Online assessment by qualified non-physician healthcare professional |
| Interprofessional Telephone/Internet/EHR Consultations | Description of Service |
| 99446 – 99449 | Interprofessional telephone/Internet/electronic health record assessment and management service provided by a consultative physician, including a verbal and written report to the patient’s treating/requesting physician or other qualified healthcare professional *Each code includes time for medical consultative discussion and review |
| 99451 | Interprofessional telephone/Internet/electronic health record assessment and management service provided by a consultative physician, including a written report to the patient’s treating/requesting physician or other qualified health care professional, 5 minutes or more of medical consultative time |
| 99452 | Interprofessional telephone/Internet/electronic health record referral service(s) provided by a treating/ requesting physician or other qualified healthcare professional, 30 minutes |
HCPCS LEVEL II CODES
HCPCS Level II codes for telemedicine services are also available for reference.
| HCPCS Level II Telehealth Codes | Service |
| G0406-G0408 | Follow-up Inpatient Consultation via Telehealth |
| G0425-G0427 | Telehealth Consultation, Emergency Department |
| G0508, G0509 | Telehealth Consultation, Critical Care |
On the CMS website, you can find a list of all the available codes for telehealth services.
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