The Centers for Medicare & Medicaid Services (CMS) made many changes to adapt patient care amid the COVID-19 pandemic. Expanding Medicare coverage to include a range of services through audio-only telehealth visits is one of them.
Let’s understand some of the basic coding guidelines for audio-only telephone visits:
CPT Code 99441-99443 -audio-only telehealth
Code Description
- 99441: Telephone evaluation and management service by a physician or other qualified health care professional who may report evaluation and management 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.
- 99442: 11-20 minutes of medical discussion
- 99443: 21-30 minutes of medical discussion
Basic Guidelines for 99441-99443
- Physicians, nurse practitioners, clinical nurse specialists, certified nurse-midwives and physician assistants use these CPT codes.
- Audio-only telephone visits were previously had a status indicator as non-covered services but now CMS will pay for phone calls using codes 99441-99443.
- In most of the cases for 99441-99443, the place of service would be office (11) or outpatient department (19, 22).
- You have to add modifier 95 since they are now telehealth services
- Telephone codes 99441–99443 require audio only but will pay at the rates of 99212–99214
| CPT Code | Non-facility payment | Facility payment |
| 99212 | $ 46.13 | $ 26.31 |
| 99213 | $ 76.04 | $ 52.26 |
| 99214 | $ 110.28 | $ 80.37 |
CPT Code 98966-98968
Other qualified health care professionals who may bill Medicare for their services, such as registered dietitians, social workers, speech-language pathologists, and physical and occupational therapists should use codes 98966-98968.
| CPT Code | Non-facility payment |
| 98966 | $13.32 |
| 98967 | $26.64 |
| 98968 | $39.60 |
Code Description
- 98966: Telephone evaluation and management service by a qualified non-physician health care professional to an established patient, parent, or guardian not originating from a related assessment and management service provided within the previous 7 days nor leading to an evaluation and management service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion.
- 98967: Telephone call 11-20 minutes
- 98968: Telephone call 21-30 minutes
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