CPT Codes for Phone Call and Online Patient Care
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CPT Codes for Telephone Care
CPT codes: 99441-99444 and 98966-98969 are effective as of January 1, 2009, relating to billing for Patient Phone calls and internet online medical care.
There are six (6) time-based codes for reporting telephone care. These new codes are intended for use in situations where an established patient is seeking advice or treatment for a problem that does not require a face-to-face visit.
There are two (2) online service codes for reporting patient care provided in an online method.
These telephone codes are time-based codes, so time spent must be documented. Both telephone care and online care require documenting the nature of the service and pertinent details for the medical record.
Medicare has assigned RVUs and pricing for these new codes. At this time Medicare has designated these codes as Non-Covered services. This means that physicians are free to bill–and be paid for–the services described by these codes. Commercial plans will develop their own coverage policies; many will follow Medicare’s lead.
Following are the descriptors for these new Non-Face-to-Face Services. Please note there are separate sets of codes for use by physicians and non-physician practitioners. Physicians will report codes from the Evaluation and Management chapter of CPT; non-physician practitioners will report codes from the Medicine chapter.
Telephone evaluation and management service provided by a physician 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;
99441 effective date: 1/1/2009 Phone E&M by Physician 5 to 10 minutes of medical discussion
99442 effective date: 1/1/2009 Phone E&M by Physician 11 to 20 minutes of medical discussion
99443 effective date: 1/1/2009 Phone E&M by Physician 21 to 31 minutes of medical discussion
Online Services – Physician
99444 effective date: 1/1/2009 Online E&M by Physician of medical discussion
Telephone Services–Non-Physician Healthcare Provider
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 seven days nor leading to an assessment and management service or procedure within the next 24 hours or soonest available appointment;
98966 effective date: 1/1/2009 Healthcare Provider phone call 5 to 10 minutes of medical discussion
98967 effective date: 1/1/2009 Healthcare Provider phone call 11 to 20 minutes of medical discussion
98968 effective date: 1/1/2009 Healthcare Provider phone call 21 to 30 minutes of medical discussion
Online Services – Non-Physician Healthcare Provider
98969 effective date: 1/1/2009 Online service by Healthcare Provider
- These codes may be reported only for established patients, not new patients.
- The patient or patient’s parent/guardian must initiate the contact. These codes may not be used for calls initiated by a provider.
- Calls resulting in a face-to-face encounter for the same problem within 24 hours are not reportable.
- If the call relates to and occurs within 7 days of another E/M service performed and reported by the same provider for the same problem, the call is not reportable. This also means that a telephone call related to a previous call within 7 days is not reportable, since these codes are themselves an E/M service.
- Calls related to and takes place within the postoperative period of a procedure performed by the same physician are not reportable and considered to be part of the global surgical package.
- Telephone calls should not be reported for care plan oversight or anticoagulation management when the same communication is reported using codes 99339-99340, 99374-99380, or 99363-99364.