Resolved Can I bill for a telephone encounter/refill request?

[JenifferR_41931]

Can I bill for a telephone encounter? For example.

The patient calls requesting refills. The Medical Assistant takes the call and makes a telephone encounter on the patient’s charts and assigns it to the physician.

The physician receives the telephone encounter note/request, reviews the patient’s chart, decides is okay to send refills or make any changes to medications makes a note, and sends the refills to the pharmacy.

Can I bill for this? And what CPT codes or HCPCS codes can I use? Do I use modifiers?

Thank you.

 

[Lori]

Please see this free resource:

Resource - Telehealth

Telemedicine-“a two-way, real- time interactive communication between a patient and a physician or practitioner at a distant site through telecommunications equipment that includes, at a minimum, audio and visual equipment.” Telemedicine services may make up 2 distinct services, depending on...

www.cco.community

Telemedicine: Ultimate Guide - Everything You Need to Know

What is telemedicine? How does it work and what are its benefits? Learn more about this rapidly expanding field in our definitive telemedicine guide.

evisit.com

Current Procedure Terminology (CPT) code

1. Evaluation and management codes: 992xx
2. Telehealth codes: 9944x

Bill the appropriate 992xx code. This can be done using standard criteria for medical decision-making or time. History and physical exam elements are not required for telemedicine, but should be appropriately documented for completeness of the medical record. Note that the 2021 standards for medical decision-making and time have changed and should be reviewed prior to use.

Providers

1. Physician: MD, DO, DPM, or chiropractor
2. Qualified health professional: PA, NP, RN

Care must be provided by the physician or QHP and not an assistant. Time spent by an assistant cannot be included if time based billing is used.

Visits

1. Synchronous: Patient and provider interact in real time
2. Asynchronous: Patient and provider are separated in time

Types of visits

1. Video visits
2. Phone visits
3. Remote patient monitoring

Modifiers and place of service

1. Modifiers: These are code add-ons that describe the specific code further
2. Place of service: Medicare requires every visit to have a place of service, and this can vary with telemedicine

Append modifier 95 to indicate it is a synchronous telemedicine visit.

Use the regular place of service code as if it were an in-person visit. For an office private practice, for example, this is POS 11.

AMA Telehealth policy, coding & payment

The AMA’s telehealth quick guide outlines policy, CPT coding and payment considerations to keep in mind during COVID-19.

www.ama-assn.org

 

[JenifferR_41931]

Thank you so much for your prompt reply this information is truly very helpful.