{"id":12530,"date":"2020-12-10T15:21:34","date_gmt":"2020-12-10T09:51:34","guid":{"rendered":"https:\/\/www.medicalbillersandcoders.com\/blog\/?p=12530"},"modified":"2024-10-04T13:00:55","modified_gmt":"2024-10-04T13:00:55","slug":"billing-for-audio-only-telehealth","status":"publish","type":"post","link":"https:\/\/www.medicalbillersandcoders.com\/blog\/billing-for-audio-only-telehealth\/","title":{"rendered":"Billing for Audio-only Telehealth"},"content":{"rendered":"<p style=\"text-align: justify;\">The Centers for Medicare &amp; 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.<\/p>\n<h2 style=\"text-align: left;\">Let\u2019s understand some of the basic coding guidelines for audio-only telephone visits:<\/h2>\n<h3 style=\"text-align: left;\">CPT Code 99441-99443 -audio-only telehealth<\/h3>\n<h4 style=\"text-align: justify;\">Code Description<\/h4>\n<ul style=\"text-align: justify;\">\n<li><strong>99441:<\/strong> Telephone evaluation and management service by a <a href=\"https:\/\/www.medicalbillersandcoders.com\/physician-group.aspx\">physician<\/a> 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.<\/li>\n<li><strong>99442:<\/strong> 11-20 minutes of medical discussion<\/li>\n<li><strong>99443:<\/strong> 21-30 minutes of medical discussion<\/li>\n<\/ul>\n<h3 style=\"text-align: left;\">Basic Guidelines for 99441-99443<\/h3>\n<ul style=\"text-align: justify;\">\n<li>Physicians, nurse practitioners, clinical nurse specialists, certified nurse-midwives and physician assistants use these CPT codes.<\/li>\n<li>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.<\/li>\n<li>In most of the cases for 99441-99443, the place of service would be office (11) or outpatient department (19, 22).<\/li>\n<li>You have to add modifier 95 since they are now telehealth services<\/li>\n<li>Telephone codes 99441\u201399443 require audio only but will pay at the rates of 99212\u201399214<\/li>\n<\/ul>\n<table>\n<tbody>\n<tr>\n<td width=\"154\"><strong>CPT Code<\/strong><\/td>\n<td width=\"154\"><strong>Non-facility payment<\/strong><\/td>\n<td width=\"154\"><strong>Facility payment<\/strong><\/td>\n<\/tr>\n<tr>\n<td width=\"154\">99212<\/td>\n<td width=\"154\">$ 46.13<\/td>\n<td width=\"154\">$ 26.31<\/td>\n<\/tr>\n<tr>\n<td width=\"154\">99213<\/td>\n<td width=\"154\">$ 76.04<\/td>\n<td width=\"154\">$ 52.26<\/td>\n<\/tr>\n<tr>\n<td width=\"154\">99214<\/td>\n<td width=\"154\">$ 110.28<\/td>\n<td width=\"154\">$ 80.37<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h3 style=\"text-align: left;\">CPT Code 98966-98968<\/h3>\n<p style=\"text-align: justify;\">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.<\/p>\n<table>\n<tbody>\n<tr>\n<td width=\"154\"><strong>CPT Code<\/strong><\/td>\n<td width=\"154\"><strong>Non-facility payment<\/strong><\/td>\n<\/tr>\n<tr>\n<td width=\"154\">98966<\/td>\n<td width=\"154\">$13.32<\/td>\n<\/tr>\n<tr>\n<td width=\"154\">98967<\/td>\n<td width=\"154\">$26.64<\/td>\n<\/tr>\n<tr>\n<td width=\"154\">98968<\/td>\n<td width=\"154\">$39.60<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h4 style=\"text-align: left;\">Code Description<\/h4>\n<ul style=\"text-align: justify;\">\n<li><strong>98966:<\/strong> 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.<\/li>\n<li><strong>98967:<\/strong> Telephone call 11-20 minutes<\/li>\n<li><strong>98968:<\/strong> Telephone call 21-30 minutes<\/li>\n<\/ul>\n<h5 style=\"text-align: left;\">About Medical Billers and Coders<\/h5>\n<p style=\"text-align: justify;\">We are catering to more than 40 specialties, <a href=\"https:\/\/bit.ly\/2G9aauK\"><strong>Medical Billers and Coders (MBC)<\/strong><\/a> is proficient in handling services that range from <a href=\"https:\/\/medicalbillersandcoders.com\/revenue-management-services.aspx\">revenue cycle management<\/a> to <a href=\"https:\/\/www.medicalbillersandcoders.com\/ICD-10.aspx\">ICD-10<\/a> testing solutions. The main goal of our organization is to assist physicians looking for billers and coders.<\/p>\n<h3>FAQs: Audio-Only Telehealth and Billing Codes<\/h3>\n<p><strong>1. What changes did CMS make regarding audio-only telehealth visits?<\/strong><br \/>\nCMS expanded Medicare coverage to include audio-only telehealth visits during the COVID-19 pandemic, allowing physicians and other healthcare professionals to be reimbursed for services provided via telephone.<\/p>\n<hr \/>\n<p><strong>2. What are CPT codes 99441-99443 used for?<\/strong><br \/>\nCPT codes 99441-99443 are used for audio-only telephone evaluations and management services provided by physicians or other qualified healthcare professionals to established patients. These codes cover telephone consultations that are not part of a previous or upcoming E\/M service.<\/p>\n<hr \/>\n<p><strong>3. How are CPT codes 99441-99443 reimbursed?<\/strong><br \/>\nCMS now reimburses telephone visits using codes 99441-99443 at the same rates as in-person visits coded 99212-99214, depending on the duration of the medical discussion.<\/p>\n<hr \/>\n<p><strong>4. Who can use CPT codes 99441-99443?<\/strong><br \/>\nPhysicians, nurse practitioners, clinical nurse specialists, certified nurse-midwives, and physician assistants can bill using these codes for audio-only telehealth visits.<\/p>\n<hr \/>\n<p><strong>5. What modifier should be added to CPT codes 99441-99443 for telehealth?<\/strong><br \/>\nModifier 95 must be added to these codes to indicate that the services were provided via telehealth.<\/p>\n<hr \/>\n<p><strong>6. What are CPT codes 98966-98968 used for?<\/strong><br \/>\nCPT codes 98966-98968 are used by non-physician healthcare professionals, such as registered dietitians, social workers, speech-language pathologists, and therapists, for telephone evaluations and management services provided to established patients.<\/p>\n<hr \/>\n<p><strong>7. What is the difference between CPT codes 99441-99443 and 98966-98968?<\/strong><br \/>\nCodes 99441-99443 are used by physicians and certain other healthcare professionals, while codes 98966-98968 are used by non-physician professionals like therapists and dietitians for audio-only telehealth services.<\/p>\n<hr \/>\n<p><strong>8. How much is reimbursed for CPT codes 98966-98968?<\/strong><br \/>\nFor telephone evaluations, 98966 reimburses $13.32, 98967 reimburses $26.64, and 98968 reimburses $39.60 for non-facility settings.<\/p>\n<hr \/>\n<p><strong>9. What services does Medical Billers and Coders (MBC) provide?<\/strong><br \/>\nMBC offers services like revenue cycle management and ICD-10 testing solutions for over 40 medical specialties, helping physicians streamline their billing and coding processes.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>The Centers for Medicare &amp; 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\u2019s understand some of the basic coding guidelines for audio-only telephone visits: CPT Code 99441-99443 -audio-only telehealth Code Description [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":12532,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2],"tags":[900,746,921,922,80,747,30,359,778,737,738,46,47,751,198,15,417,162,9,11,64,339,146,192,753,754,418,144,815,816,699,86,205,904,58,34,27,785,923],"class_list":["post-12530","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-medical-billing-services","tag-account-receivable","tag-billing-services-for-doctors","tag-coronavirus","tag-covid-19","tag-cpt-codes","tag-cpthcpcs","tag-credentialing","tag-dme-billing-services","tag-dmepos","tag-e-m-codes","tag-e-m-services","tag-ehr","tag-emr-ehr-health-it","tag-hcpcs-code","tag-hospital-billing","tag-medical-billing","tag-medical-billing-agencies","tag-medical-billing-and-coding-services","tag-medical-billing-companies","tag-medical-billing-outsourcing","tag-medical-billing-practices","tag-medical-coding-audits","tag-medicare-2","tag-medicare-medicaid-services","tag-medicare-billing","tag-modifier","tag-online-medical-billing","tag-outsource-medical-billing","tag-outsourced-medical-billing-company","tag-outsourced-medical-billing-services","tag-outsourcing-primary-care-billing","tag-physician-billing","tag-physician-bundle-payment","tag-prior-authorization","tag-rcm","tag-reimbursement","tag-revenue-cycle-management-2","tag-telehealth","tag-vaccine"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.8 (Yoast SEO v27.8) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Billing for Audio-only Telehealth<\/title>\n<meta name=\"description\" content=\"CMS made changes to adapt patient care amid COVID-19 pandemic. 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