2021 Coding for Telehealth, Telephone E/M and Virtual ...
2021 Coding for Telehealth, Telephone E/M and Virtual
Check-ins
Patricia Garcia, MD
AGA RUC Alternate Advisor
Types of Telemedicine Services
? Video Visits: E/M video visits provided via realtime audio/visual technology (synchronous)
? Telephone E/M: E/M provided over the phone (synchronous)
? Online digital E/M: E/M provided via practice's secure patient portal (asynchronous)
? Virtual check-ins: Doctor-patient interactions via e-mail or portal (asynchronous)
2021 Coding during COVID-19: Video Visits
New Patient
CPT MDM 99201 Deleted 99202 Straightforward 99203 Low complexity 99204 Moderate complexity 99205 High complexity
Established Patient
2021 Time Range CPT
MDM
NA
99211 NA
15-29 min 99212 Straightforward
30-44 min 99213 Low complexity
45-59 min 99214 Moderate complexity
60-74 min 99215 High complexity
2021 Time Range NA
10-19 min 20-29 min 30-39 min 40-54 min
***Consult codes 99241-99245 follow the pre-2021 rules!
Modifiers & POS for Medicare Telehealth
? Video visits and telephone E/M
are deemed telehealth during
the COVID-19 PHE
POS 11 -
? Modifier -95 identifies the
Service Mod office
service as telehealth
Video visit -95 $113.75
? Report POS where the visit
99203
3.26 RVU
would have taken place in
Video visit -95 $92.47
person
99213
2.65 RVU
Phone E/M -95 $56.88
? Do not report POS 02; it will 99441
1.63 RVU
result in a lower payment if your
practice is office-based
POS 22 ? hospital outpatient dept
$84.44 2.42 RVU
$68.04 1.95 RVU
$36.29 1.04 RVU
POS 02 telehealth
$84.44 2.42 RVU
$68.04 1.95 RVU
$36.29 1.04 RVU
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