Code and Bill Correctly During COVID-19

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MAY 18, 2020 — The Coding Expert Answers Your Questions

Betsy Nicoletti, MS, a nationally recognized coding expert, will take your coding questions via email and provide guidance on how to code properly to maximize reimbursement. Have a question about coding? Send it here.

In this column, Nicoletti discuses a recent decision by the government to align rates for telephone-based visits with those for face-to-face office visits.

Getting Paid for Patient Visits Over the Phone

Q: The Centers for Medicare & Medicaid Services (CMS) says it will now pay for telephone visits during the public health emergency at the same rate as for in-office visits. How does my internal medicine practice code for these visits correctly? How do these codes differ from telemedicine codes?

A: With all of the changes that CMS has implemented since the beginning of the COVID-19 crisis, this one has generated a great deal of questions; several physicians have asked about this.

In March, CMS announced that it would pay for telephone call codes, using codes that were previously noncovered, for services provided with audio only. The change in policy was part of a wide package announced by the Trump Administration amid the COVID-19 pandemic and came on the heels of earlier announcements broadening the use of telemedicine.

Many medical practices were disappointed in telehealth rates and told Medicare that not all of their patients have the equipment needed for evaluation and management (E/M) services via telemedicine, which requires audio and visual real-time interactive technology.

On April 30, CMS announced that it would increase the payment for audio-only phone calls and made the increased payment retroactive to March 1, 2020.

It added the codes 99441-99443 to the Medicare telehealth list, for practitioners who have E/M in their scope of practice. This includes physicians, nurse practitioners, clinical nurse specialists, certified nurse midwives, and physician assistants.

Here are details on the codes:

99441: Telephone E/M service by a physician or other qualified healthcare professional who may report E/M services provided 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; 5-10 minutes of medical discussion.

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