New CPT Codes for Digital Therapies and Telemedicine

Physicians and health professionals can simply administer safe and secure treatments to the patients affected by COVID or non-COVID patients via telemedicine. Likewise, it allows small healthcare practices to remain in business and provides the services they offer. The rapid advancements in technology have led to the rise of this unique technology which allows patients to schedule appointments, view their prior medical or clinical history, and communicate with their doctors. The concept of distance learning and telemedicine will continue to improve remote clinical healthcare and expand Chiropractic Billing Services in the forthcoming years.

However, if you want to track telehealth correctly, reimbursements can instantly impact the ground of your healthcare practice. We have compiled a new list of CPT codes for digital therapies, and telemedicine helps you to facilitate the intuitive management of telehealth billing prospects.

Telemedicine/Telehealth for CPT Codes

The following codes are usually reported for Medicare patients:

Telehealth Visits CPT Codes Service Description
99201-99205Office or Outdoor patient examining and management (E/M) visits, recent consultations, emergency department, or initial inpatient (Medicare required)
G0425-G0427Office or Outdoor patient examining and management (E/M) visits, recent consultations, emergency department, or initial inpatient (Medicare required)

Virtual Appointments or Check-Ins 

CPT CodesService Description
CPT Code G2010Distance evaluation of recorded videos or images are submitted by an established patient (i.e., store and forward) consisting of integration with the initial follow-up with the patient 24/7 business hours, that doesn’t originate from an associated E/M service provided within the previous seven days, and it doesn’t lead to an E/M service or process in about next 24 hours or the soonest available appointment
CPT Code G2012In-depth communication technology-based service, i.e., virtual check-in by a physician or relevant qualified healthcare experts who can report the evaluation and management services provided to an established patient that doesn’t originate from an associated E/M service provided within the previous seven days that doesn’t lead to an E/M service or process within the upcoming 24 hours or the instantly available appointment, i.e., 5-10 medical discussion minutes. 

In particular, the Centers for Medicare & Medicaid Services (CMS) creates two extra G codes for medical billing by the experts who cannot bill independently for E/M services. G2250 and G2251 are CPT codes billable by a particular group of non-physician specialists as per their benefit categories. 

HCPCS G CodeService Description
G2250An official patient submits a remote evaluation of recorded video or images, i.e., store and forward, that includes follow-up interpretation with the patient within the next 24 business hours that doesn’t originate from a relevant service provided within the previous seven days that doesn’t lead to a service or process within the upcoming 24 hours or early available appointments or meetings.
G2251In-depth communication service-based technology, i.e., who can’t report the evaluation and management reports, offered to an established patient that doesn’t originate from an associated E/M service provided within the previous seven days that doesn’t lead to a service or process within the upcoming 24 hours or early availability of appointments, i.e., 5-10 minutes of medical discussion.
G2252 (CMS permanently allows the identical coding and payment for the additional virtual check-in service, G2252 effective 01-01-2022. The overall reimbursement amount has been cross-engaged to the compensation for current procedural terminology (CGP)In-depth communication technology-driven service, i.e., virtual check-in with a physician or relevant qualified healthcare expert who can report evaluation and management solutions offered to an established patient that doesn’t originate from an associated E/M service provided within the previous seven days doesn’t result in an E/M service or process within the upcoming 24 hours or earliest available appointment i.e., 11-20 minutes of medical discussions and appointments.

Telecommunication Evaluation & Management (E/M) Services

Primarily, the CPT codes for telephonic E/M are based on significant time intervals. In particular, payments to be sent for telephonic E/M services CPT codes 99441-99443 are equivalent to 99212-99214 and can be used for new or established patients within the Public Health Emergency (PHE). The modifier 95 must be applied, and the place of service (POS) should be visited that would have taken place in person before the public health emergency (i.e., 11-Office, 22-Hospital Outpatient, 23-ASC). Before reporting codes for non-medicare beneficiaries, you must ensure that all of your commercial payers must cover all such services.

CPT Code 99441For additional or established patients, telephonic equipment or audio-based examination and managerial solutions cannot be generated from a relevant E/M service provided in the past seven days doesn’t lead to an E/M service or procedure within the forthcoming 24 hours or as soon as the earliest availability of appointments, 5-10 minutes of medical discussion 
CPT Code 9944211-20 medical discussion minutes 
CPT Code 9944321-30 medical discussion minutes

Medicare and some Medicaid programs recently cover them based on provisions

E-VisitsService Description
99421 – 99423Online digital management and evaluation service for a particular patient upto 7 consecutive days with a cumulative time within a week or seven days
G2061 – G2063Online Assessment by the leading non-physician healthcare personnel
Interprofessional Telephonic/WWW/EHR Meetings & DiscussionsService Description
99446 – 99449Interprofessional telephonic/WWW/digital health record evaluation and management service provided by a consultant physician constituting of a verbal and written report to the patient’s treatment or requesting a physician or other qualified healthcare expert
99451-99452Each code consists of a particular time for a medical consultant’s discussion and follow upwith a interprofessional telephonic/WWW/digital health record evaluation and managerial service offered by a consultant physician that includes a written report to the patient treatment or requesting physician or relevant qualified healthcare expert, 5 minutes or extra time of medical consultation time interprofessional telephonic/WWW/digital health record referral solutions offered by a consultant physician or specialized healthcare experts within 30 minutes.

Summary

Hospitals and Healthcare systems are expanding the concept of digital care to the home or other non-conventional configurations and work strategies with patients and relevant healthcare experts to improve results and decrease costs.