From the Guidelines
Common CPT codes for telehealth visits include 99202–5 or 99211–15, with a specific Place of Service code and telehealth CPT modifier (eg, 95, GQ or GT) based on payer specifications. These codes are used for billing telehealth visits, with the specific code depending on visit complexity and whether the patient is new or established 1. The use of these codes has been facilitated by the 2021 coding changes, which eliminated the requirement to document physical examination findings to support coding levels 1. Additionally, virtual check-in codes and online digital evaluation codes may also be used for telehealth services. It's essential to verify current telehealth coding requirements with individual payers, as telehealth policies continue to evolve 1.
Some key considerations for telehealth visits include:
- Using a technology that is appropriate to the clinical work, with a bandwidth of at least 384 Kb/s to facilitate detection of clinical details 1
- Choosing a technology approach, such as standards-based applications, consumer-grade applications, or mobile devices 1
- Considering funding models, such as contracted services, billing third-party payers per session, or other revenue-generating and risk-sharing models 1
- Using modifier "95" to indicate that services were provided using telemedicine technology, which requires an interactive audio and video telecommunications system that permits real-time communication between the beneficiary and the provider 1
Overall, the use of telehealth services has expanded in recent years, and it's essential to stay up-to-date with the latest coding requirements and guidelines to ensure proper billing and reimbursement 1.
From the Research
CPT Codes for Telehealth Visits
- There are no specific CPT codes mentioned in the provided studies for telehealth visits 2, 3, 4, 5, 6.
- The studies focus on the effectiveness and implementation of telehealth and remote patient monitoring technologies, but do not provide information on CPT codes.
- Telehealth visits may be billed using various CPT codes, depending on the type of service provided and the patient's condition, but this information is not available in the provided studies.
Telehealth and Remote Patient Monitoring
- Telehealth and remote patient monitoring technologies have been shown to be effective in improving patient care and reducing hospitalizations 3, 4, 6.
- These technologies can be used to monitor patients with chronic conditions, such as COPD, and provide timely interventions to prevent exacerbations 3.
- However, there are barriers to the adoption of these technologies, including equity-related barriers, such as affordability and access to technology, and the need for quality "best practice" guidelines 5.
Factors Influencing the Effectiveness of Remote Patient Monitoring
- The effectiveness of remote patient monitoring interventions can be influenced by various factors, including the targeting of high-risk populations, accurate detection of declines in health, and provision of responsive and timely care 6.
- Personalizing care, enhancing self-management, and ensuring collaborative and coordinated care are also important factors in the success of remote patient monitoring interventions 6.
- Understanding these factors can help clinicians, researchers, and policymakers design and implement effective remote patient monitoring interventions.