The Centers for Medicare & Medicaid Services (CMS) has expanded the telehealth services for Medicare during the COVID-19 public health emergency. This service has been expanded to allow telephone-only services to be billed. The article also goes over how to bill the newly approved services.
Under the Coronavirus Preparedness and Response Supplemental Appropriations Act and Section 1135 waiver authority of the Social Security Act, on March 6, 2020, CMS broadened access to Medicare telehealth services, so beneficiaries can get a wider range of services from their doctors and other clinicians without traveling to a health care facility. Under the Coronavirus Aid, Relief, and Economic Security Act (CARES) Act, CMS is waiving the requirements for use of interactive telecommunications systems to furnish telehealth services, to the extent they require use of video technology, for certain services.
Note: These guidelines are effective for dates of service (DOS) on and after March 1, 2020, until the end of the designated public health emergency (PHE).
You can now provide the following services for new and established patients:
Telehealth services - A visit with a provider that uses telecommunication systems that has audio and video capabilities between a provider and a patient
The use of audio-only equipment to furnish services described by the codes for audio-only telephone evaluation and management (E&M) services, and behavioral health counseling and educational services:
Includes 99441-99443 (Non-face-to-face physician telephone services)
Real-time, two-way, audio/video telecommunication capabilities is needed.
When billing professional claims for all telehealth services with DOS on or after March 1, 2020, and for the duration of the PHE, bill with:
Place of service (POS) equal to what it would have been had the service been furnished in-person.
Modifier 95 indicating that the service rendered was actually performed via telehealth
Note: Modifier 95 is only required for telehealth services
The complete list of all Medicare telehealth services can be found on the
CMS website.
Virtual check-ins - A brief (5-10 minutes) check in with your practitioner via telephone or other telecommunications device to decide whether an office visit or other service is needed. A remote evaluation of recorded video and/or images.
Healthcare Procedure Coding System codes G2010 and G2012 may only be reported when they do not result in an in-person or telehealth visit.
Bill the appropriate code with the POS where the service would normally take place.
E-visits - A communication between a patient and their provider through an online patient portal
Codes include:
99421 – 99423 (online digital E&M services)
G2061 – G2063 (qualified non-physician qualified health care)
Bill the appropriate code with the POS where the service would normally take place.
Telephone services - Non-face-to-face E&M services provided using telephone audio
Codes include:
98966 – 98968 (Non-face-to-face non-physician telephone services)
Note: 98966-98968 can be billed by occupational therapists, physical therapist, speech language pathologist, clinical psychologists, and clinical social workers
99441 – 99443 (Non-face-to-face physician telephone services) (*)
Note: (*) Follow the guidance listed for telehealth services
Bill the appropriate code with the POS where the service would normally take place.
Telemedicine Service |
Description |
HCPSS/CPT
Codes |
Place of Service |
Telehealth |
A visit with a provider that uses telecommunication systems that has audio and video capabilities between a provider and a patient The use of audio-only equipment to furnish services described by the codes for audio-only telephone E&M services, and behavioral health counseling and educational services Includes 99441-99443 |
Review the complete listing of Medicare Telehealth Services Report modifier 95 indicating that the service rendered was actually performed via telehealth |
Report the POS equal to what it would have been had the service been furnished in-person. |
Virtual Check-In |
A brief (5-10 minutes) check in with your practitioner via telephone or other telecommunications device to decide whether an office visit or other service is needed. A remote evaluation of recorded video and/or images. |
G2010 G2012 |
Report the POS equal to what it would have been had the service been furnished in-person. |
E-Visits |
A communication between a patient and their provider through an online patient portal |
99421 – 99423 G2061 – G2063 |
Report the POS equal to what it would have been had the service been furnished in-person. |
Telephone Services |
Non-face-to-face E&M services provided using telephone audio |
99441 – 99443 (* Follow guidance for telehealth) 98966 – 98968 |
Report the POS equal to what it would have been had the service been furnished in-person. |
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