{"id":14886,"date":"2022-01-13T23:26:58","date_gmt":"2022-01-13T23:26:58","guid":{"rendered":"https:\/\/www.medicalbillersandcoders.com\/blog\/?p=14886"},"modified":"2026-05-19T13:48:09","modified_gmt":"2026-05-19T08:18:09","slug":"cpt-codes-for-digital-e-m-service","status":"publish","type":"post","link":"https:\/\/www.medicalbillersandcoders.com\/blog\/cpt-codes-for-digital-e-m-service\/","title":{"rendered":"CPT Codes for Digital E\/M Service"},"content":{"rendered":"<p><span style=\"font-weight: 400;\">In the 2020 CPT codes set, CMS six released new codes to report online digital evaluation services or e-visits. The codes describe patient-initiated digital communications provided by physicians or other qualified health professionals, codes are 99421, 99422, and 99423. <\/span><\/p>\r\n<p><span style=\"font-weight: 400;\">Three others who describe similar interactions when they involve a nonphysician health professional are 98970, 98971, and 98972. The new codes are spurred by digital health tools that are growing in popularity, such as patient portals. <\/span><\/p>\r\n<p><span style=\"font-weight: 400;\">These tools enable patients and physicians to connect asynchronously and outside of face-to-face settings, making it easier for patients with transportation and scheduling barriers to get questions answered and receive care.<\/span><\/p>\r\n<p><span style=\"font-weight: 400;\">These six new codes will help physicians and others report a range of digital health services including electronic visits through secure patient portal messages. Digital evaluation and management services are not considered as telehealth services, so do not use POS 02 and modifier 95. <\/span><\/p>\r\n<p><span style=\"font-weight: 400;\">CMS is requiring verbal consent for communication-based technology services (CBTS). This verbal consent is required annually and encompasses all CBTS, not a consent\/service or consent for each provision of the service.\u00a0<\/span><\/p>\r\n<h2><strong>CPT Codes for Digital E\/M Service<\/strong><\/h2>\r\n<p><span style=\"font-weight: 400;\">For Qualified Health Professionals (QHP)<\/span><\/p>\r\n<ul>\r\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">CPT Code 99421: Online digital evaluation and management (E\/M) service, for an established patient, for up to 7 days cumulative time during the 7 days; 5-10 minutes<\/span><\/li>\r\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">CPT Code 99422: 11-20 minutes<\/span><\/li>\r\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">CPT Code 99423: 21 or more minutes<\/span><\/li>\r\n<\/ul>\r\n<p><span style=\"font-weight: 400;\">Above mentioned codes are for use when E\/M services are performed, of a type that would be done face-to-face, through a HIPAA compliant secure platform. <\/span><\/p>\r\n<p><span style=\"font-weight: 400;\">These are for patient-initiated communications and may be billed by clinicians who may independently bill an E\/M service. They may not be used for work done by clinical staff or for clinicians who do not have E\/M services in their scope of practice.<\/span><\/p>\r\n<p><span style=\"font-weight: 400;\">Defining 7-day period: The seven-day period begins with the physician\u2019s or other qualified health care professional\u2019s (QHP) initial, personal review of the patient-generated inquiry. <\/span><\/p>\r\n<p><span style=\"font-weight: 400;\">Physician\u2019s or other QHP\u2019s cumulative service time includes a review of the initial inquiry, review of patient records or data pertinent to assessment of the patient\u2019s problem, personal physician or other QHP interaction with clinical staff focused on the patient\u2019s problem, development of management plans, including a physician or other QHP generation of prescriptions or ordering of tests, and subsequent communication with the patient through online, telephone, email, or other digitally supported communication, which does not otherwise represent separately reported E\/M service.<\/span><\/p>\r\n<div>\r\n<div class=\"standard-markdown grid-cols-1 grid [&amp;_&gt;_*]:min-w-0 gap-3\">\r\n<p class=\"font-claude-response-body break-words whitespace-normal leading-[1.7]\">Digital E\/M services \u2014 billed under CPT codes 99421, 99422, and 99423 \u2014 represent one of the most underleveraged <a href=\"https:\/\/www.medicalbillersandcoders.com\/pricing?utm_source=pricing-sab&amp;utm_medium=blog%28sab%29&amp;utm_campaign=blog%28sab%29&amp;utm_id=pricing-sab&amp;utm_term=19%2F05%2F2026SAB&amp;utm_content=%28SAB%29\">yield EBITDA opportunities in primary care and multi-specialty group practices today<\/a>. The financial mechanics are straightforward: 99421 reimburses for 5\u201310 minutes of cumulative physician time, while 99423 reimburses for 21 or more minutes \u2014 a reimbursement differential of $45\u2013$75 per encounter.<\/p>\r\n<p class=\"font-claude-response-body break-words whitespace-normal leading-[1.7]\">When practices fail to track cumulative 7-day interaction time accurately, they systematically bill at the lowest tier regardless of the actual clinical work performed, compressing EBITDA encounter by encounter without any single claim signaling the problem. For a practice handling 30 digital E\/M interactions weekly, the annual yield EBITDA impact of defaulting to 99421 when 99423 is clinically supported exceeds $100,000 in recoverable margin \u2014 revenue that requires no additional patient volume, only accurate time documentation and correct code selection.<\/p>\r\n<\/div>\r\n<\/div>\r\n<h2><strong>Coding Guidelines<\/strong><\/h2>\r\n<ul>\r\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Codes are applicable only for established patients.<\/span><\/li>\r\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">As mentioned above, verbal consent is required by CMS. This verbal consent is required annually and encompasses all CBTS, not a consent\/service or consent for each provision of the service.<\/span><\/li>\r\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">The patient initiates the service with an inquiry through the portal.\u00a0<\/span><\/li>\r\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">If the patient had an E\/M service within the last seven days, these codes may not be used for that problem. If the inquiry is about a new problem (from the problem addressed at the E\/M service in the past 7 days), these codes may be billed.<\/span><\/li>\r\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">If within seven days of the initiation of the online service a face-to-face E\/M service occurs, then the time of the online service or decision-making complexity may be used to select the E\/M service, but this service may not be billed.<\/span><\/li>\r\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">This may not be billed by surgeons during the global period.<\/span><\/li>\r\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">The digital service must be provided via a HIPAA compliant platform, such as an electronic health record portal, secure email, or other digital applications.<\/span><\/li>\r\n<\/ul>\r\n<p class=\"font-claude-response-body break-words whitespace-normal leading-[1.7]\"><a href=\"https:\/\/www.medicalbillersandcoders.com\/revenue-management-services.aspx?utm_source=revenue-management-services-sab&amp;utm_medium=blog%28sab%29&amp;utm_campaign=blog%28sab%29&amp;utm_id=revenue-management-services-sab&amp;utm_term=19%2F05%2F2026SAB&amp;utm_content=%28SAB%29\">Revenue integrity in digital E\/M billing<\/a> rests on three foundational compliance requirements that are frequently misapplied simultaneously: the patient-initiated inquiry rule, the HIPAA-compliant platform requirement, and the mutual exclusivity of digital E\/M codes from both telehealth (POS 02 \/ modifier 95) and telephone-only E\/M codes (99441\u201399443).<\/p>\r\n<p class=\"font-claude-response-body break-words whitespace-normal leading-[1.7]\">When any one of these distinctions is blurred \u2014 most commonly when practices submit portal-based asynchronous interactions under telehealth place-of-service designators, or when clinical staff time is inadvertently folded into the physician&#8217;s cumulative 7-day time calculation \u2014 the result is not just a denied claim but a compliance exposure that survives the denial itself.<\/p>\r\n<p class=\"font-claude-response-body break-words whitespace-normal leading-[1.7]\">True revenue integrity for digital E\/M services also requires that annual verbal consent documentation for communication-based technology services (CBTS) is recorded and retrievable, as its absence during a payer audit converts a billing question into a regulatory finding. Practices operating multi-provider group settings carry the highest revenue integrity risk in this category, particularly where care coordination time is shared across providers but reported under a single billing physician.<\/p>\r\n<h2><strong>For Qualified Nonphysician Health Care Professionals<\/strong><\/h2>\r\n<p><span style=\"font-weight: 400;\">For online digital E\/M services provided by a qualified nonphysician health care professional who may not report the physician or other qualified health care professional E\/M services (e.g., speech-language pathologists, physical therapists, occupational therapists, social workers, dietitians), applicable codes are 98970, 98971, and 98972. <\/span><\/p>\r\n<p><span style=\"font-weight: 400;\">CMS, however, said in the 2020 Final Rule that they would not recognize these codes, because they are defined by CPT as \u2018evaluation and management services, and <a href=\"https:\/\/www.cms.gov\/\">CMS<\/a> reserves those words exclusively for physicians, advance practice nurse practitioners, and physician assistants. These codes have a status indicator of invalid in the Medicare fee schedule and don\u2019t have RVUs assigned to them.<\/span><\/p>\r\n<ul>\r\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">CPT Code 98970: Qualified nonphysician health care professional online digital evaluation and management service, for an established patient, for up to 7 days, a cumulative time during the 7 days; 5-10 minutes.\u00a0<\/span><\/li>\r\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">CPT Code 98971: 11-20 minutes<\/span><\/li>\r\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">CPT Code 98972: 21 minutes or more<\/span><\/li>\r\n<\/ul>\r\n<p class=\"font-claude-response-body break-words whitespace-normal leading-[1.7]\">A <a href=\"https:\/\/www.medicalbillersandcoders.com\/contact-us.aspx?utm_source=contact-us-sab&amp;utm_medium=blog%28sab%29&amp;utm_campaign=blog%28sab%29&amp;utm_id=contact-us-sab&amp;utm_term=19%2F05%2F2026SAB&amp;utm_content=%28SAB%29\">revenue diagnostic focused on digital E\/M billing<\/a> \u2014 codes 99421 through 99423 and 98970 through 98972 \u2014 consistently surfaces three patterns that standard denial reporting does not capture.<\/p>\r\n<ul>\r\n<li class=\"font-claude-response-body break-words whitespace-normal leading-[1.7]\">First, it identifies cumulative time undercounting: practices that track only the initial patient message review rather than the full 7-day physician interaction window, including record review, prescription generation, and follow-up digital communication, routinely qualify for 99423 but bill 99421.<\/li>\r\n<li class=\"font-claude-response-body break-words whitespace-normal leading-[1.7]\">Second, it reveals cross-pathway billing errors where digital E\/M encounters have been submitted with telehealth place-of-service codes, generating automated payer edits that result in denials without appeal opportunity at most commercial payers.<\/li>\r\n<li class=\"font-claude-response-body break-words whitespace-normal leading-[1.7]\">Third, a thorough revenue diagnostic examines whether nonphysician provider interactions are being appropriately separated \u2014 given that CMS does not recognize codes 98970\u201398972 for Medicare billing, practices that apply these codes to Medicare encounters are generating zero-reimbursement claims for services that could be redirected through a qualifying billing pathway.<\/li>\r\n<\/ul>\r\n<p class=\"font-claude-response-body break-words whitespace-normal leading-[1.7]\">For most primary care and multi-specialty practices, this diagnostic exercise recovers $70,000\u2013$117,000 or more in annually billable revenue within the first quarter reviewed.<\/p>\r\n<p><i><span style=\"font-weight: 400;\">*CPT is a registered trademark of the American Medical Association (AMA) Copyright 2022<\/span><\/i><\/p>\r\n<p><b>Medical Billers and Coders (MBC)<\/b><span style=\"font-weight: 400;\"> is a <a href=\"https:\/\/www.medicalbillersandcoders.com\/\">leading medical billing company<\/a> providing complete revenue cycle services. Most providers make the mistake of billing digital E\/M services as telehealth services, and end up with denied payments. <\/span><\/p>\r\n<p><span style=\"font-weight: 400;\">We can help you in each process of <a href=\"https:\/\/www.medicalbillersandcoders.com\/medical-billing-outsourcing.aspx\">outsourcing medical billing<\/a> to ensure that you will receive accurate insurance reimbursements. To know more about our medical billing services, contact us at: <a href=\"mailto:info@medicalbillersandcoders.com\">info@medicalbillersandcoders.com<\/a>\/ <strong><a href=\"tel:888-357-3226\">888-357-3226<\/a><\/strong><\/span><\/p>\r\n<h2>FAQs<\/h2>\r\n\r\n<div class=\"schema-faq wp-block-yoast-faq-block\">\r\n<div id=\"faq-question-1746436770722\" class=\"schema-faq-section\"><strong class=\"schema-faq-question\">1. What are digital E\/M services?<\/strong>\r\n<p class=\"schema-faq-answer\">Digital E\/M services are patient-initiated online evaluations provided by physicians or qualified health professionals through secure communication platforms, such as patient portals.<\/p>\r\n<\/div>\r\n<div id=\"faq-question-1746436783480\" class=\"schema-faq-section\"><strong class=\"schema-faq-question\">2. What CPT codes are used for digital E\/M services by physicians?<\/strong>\r\n<p class=\"schema-faq-answer\">The CPT codes for digital E\/M services by physicians are 99421 (5-10 minutes), 99422 (11-20 minutes), and 99423 (21 minutes or more), applicable for established patients over a 7-day period.<\/p>\r\n<\/div>\r\n<div id=\"faq-question-1746436792376\" class=\"schema-faq-section\"><strong class=\"schema-faq-question\">3. Can digital E\/M services be billed as telehealth services?<\/strong>\r\n<p class=\"schema-faq-answer\">No, digital E\/M services are not considered telehealth services and should not use POS 02 or modifier 95 when billed.<\/p>\r\n<\/div>\r\n<div id=\"faq-question-1746436802548\" class=\"schema-faq-section\"><strong class=\"schema-faq-question\">4. What is the role of verbal consent in digital E\/M services?<\/strong>\r\n<p class=\"schema-faq-answer\">CMS requires verbal consent from patients for communication-based technology services (CBTS). This consent is required annually and covers all digital E\/M services.<\/p>\r\n<\/div>\r\n<div id=\"faq-question-1746436812175\" class=\"schema-faq-section\"><strong class=\"schema-faq-question\">5. What digital E\/M codes are available for nonphysician health professionals?<\/strong>\r\n<p class=\"schema-faq-answer\">Nonphysician health professionals use CPT codes 98970 (5-10 minutes), 98971 (11-20 minutes), and 98972 (21 minutes or more) for digital E\/M services, but CMS does not recognize these codes for Medicare billing.<\/p>\r\n<\/div>\r\n<div id=\"faq-question-1746436852795\" class=\"schema-faq-section\"><strong class=\"schema-faq-question\">6. What are the requirements for billing digital E\/M services?<\/strong>\r\n<p class=\"schema-faq-answer\">Digital E\/M services must be initiated by the patient, provided through a HIPAA-compliant platform, and are only for established patients.<\/p>\r\n<\/div>\r\n<div id=\"faq-question-1746436864836\" class=\"schema-faq-section\"><strong class=\"schema-faq-question\">7. Can digital E\/M codes be billed during a global surgery period?<\/strong>\r\n<p class=\"schema-faq-answer\">No, digital E\/M services cannot be billed by surgeons during the global period.<\/p>\r\n<\/div>\r\n<div id=\"faq-question-1746436876873\" class=\"schema-faq-section\"><strong class=\"schema-faq-question\">8. What happens if a face-to-face E\/M service occurs within seven days of a digital E\/M service?<\/strong>\r\n<p class=\"schema-faq-answer\">If a face-to-face E\/M service occurs within seven days, the time spent on the digital E\/M service can be considered for selecting the E\/M code, but the digital service cannot be billed separately.<\/p>\r\n<\/div>\r\n<\/div>\r\n","protected":false},"excerpt":{"rendered":"<p>In the 2020 CPT codes set, CMS six released new codes to report online digital evaluation services or e-visits. The codes describe patient-initiated digital communications provided by physicians or other qualified health professionals, codes are 99421, 99422, and 99423. Three others who describe similar interactions when they involve a nonphysician health professional are 98970, 98971, [&hellip;]<\/p>\n","protected":false},"author":9,"featured_media":29807,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2],"tags":[2796,1746,3131,3132,3133,3134,3135,738,3136,3102,9,12,163,816,710,3138,549,5842,5883],"class_list":["post-14886","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-medical-billing-services","tag-accurate-insurance-reimbursements","tag-coding-guidelines","tag-cpt-code-99421","tag-cpt-code-99422","tag-cpt-code-99423","tag-cpt-codes-for-digital-e-m-service","tag-cpt-codes-set","tag-e-m-services","tag-hipaa-compliant-secure-platform","tag-leading-medical-billing-company","tag-medical-billing-companies","tag-medical-billing-services-2","tag-outsourced-medical-billing","tag-outsourced-medical-billing-services","tag-outsourcing-medical-billing","tag-outsourcing-medical-billing-service","tag-outsourcing-medical-billing-services","tag-revenue-integrity-partner","tag-yield-ebitda"],"yoast_head":"<!-- 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What CPT codes are used for digital E\/M services by physicians?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"The CPT codes for digital E\/M services by physicians are 99421 (5-10 minutes), 99422 (11-20 minutes), and 99423 (21 minutes or more), applicable for established patients over a 7-day period.","inLanguage":"en-US"},"inLanguage":"en-US"},{"@type":"Question","@id":"https:\/\/www.medicalbillersandcoders.com\/blog\/cpt-codes-for-digital-e-m-service\/#faq-question-1746436792376","position":3,"url":"https:\/\/www.medicalbillersandcoders.com\/blog\/cpt-codes-for-digital-e-m-service\/#faq-question-1746436792376","name":"3. Can digital E\/M services be billed as telehealth services?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"No, digital E\/M services are not considered telehealth services and should not use POS 02 or modifier 95 when billed.","inLanguage":"en-US"},"inLanguage":"en-US"},{"@type":"Question","@id":"https:\/\/www.medicalbillersandcoders.com\/blog\/cpt-codes-for-digital-e-m-service\/#faq-question-1746436802548","position":4,"url":"https:\/\/www.medicalbillersandcoders.com\/blog\/cpt-codes-for-digital-e-m-service\/#faq-question-1746436802548","name":"4. What is the role of verbal consent in digital E\/M services?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"CMS requires verbal consent from patients for communication-based technology services (CBTS). This consent is required annually and covers all digital E\/M services.","inLanguage":"en-US"},"inLanguage":"en-US"},{"@type":"Question","@id":"https:\/\/www.medicalbillersandcoders.com\/blog\/cpt-codes-for-digital-e-m-service\/#faq-question-1746436812175","position":5,"url":"https:\/\/www.medicalbillersandcoders.com\/blog\/cpt-codes-for-digital-e-m-service\/#faq-question-1746436812175","name":"5. What digital E\/M codes are available for nonphysician health professionals?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"Nonphysician health professionals use CPT codes 98970 (5-10 minutes), 98971 (11-20 minutes), and 98972 (21 minutes or more) for digital E\/M services, but CMS does not recognize these codes for Medicare billing.","inLanguage":"en-US"},"inLanguage":"en-US"},{"@type":"Question","@id":"https:\/\/www.medicalbillersandcoders.com\/blog\/cpt-codes-for-digital-e-m-service\/#faq-question-1746436852795","position":6,"url":"https:\/\/www.medicalbillersandcoders.com\/blog\/cpt-codes-for-digital-e-m-service\/#faq-question-1746436852795","name":"6. What are the requirements for billing digital E\/M services?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"Digital E\/M services must be initiated by the patient, provided through a HIPAA-compliant platform, and are only for established patients.","inLanguage":"en-US"},"inLanguage":"en-US"},{"@type":"Question","@id":"https:\/\/www.medicalbillersandcoders.com\/blog\/cpt-codes-for-digital-e-m-service\/#faq-question-1746436864836","position":7,"url":"https:\/\/www.medicalbillersandcoders.com\/blog\/cpt-codes-for-digital-e-m-service\/#faq-question-1746436864836","name":"7. Can digital E\/M codes be billed during a global surgery period?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"No, digital E\/M services cannot be billed by surgeons during the global period.","inLanguage":"en-US"},"inLanguage":"en-US"},{"@type":"Question","@id":"https:\/\/www.medicalbillersandcoders.com\/blog\/cpt-codes-for-digital-e-m-service\/#faq-question-1746436876873","position":8,"url":"https:\/\/www.medicalbillersandcoders.com\/blog\/cpt-codes-for-digital-e-m-service\/#faq-question-1746436876873","name":"8. What happens if a face-to-face E\/M service occurs within seven days of a digital E\/M service?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"If a face-to-face E\/M service occurs within seven days, the time spent on the digital E\/M service can be considered for selecting the E\/M code, but the digital service cannot be billed separately.","inLanguage":"en-US"},"inLanguage":"en-US"}]}},"_links":{"self":[{"href":"https:\/\/www.medicalbillersandcoders.com\/blog\/wp-json\/wp\/v2\/posts\/14886","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.medicalbillersandcoders.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.medicalbillersandcoders.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.medicalbillersandcoders.com\/blog\/wp-json\/wp\/v2\/users\/9"}],"replies":[{"embeddable":true,"href":"https:\/\/www.medicalbillersandcoders.com\/blog\/wp-json\/wp\/v2\/comments?post=14886"}],"version-history":[{"count":7,"href":"https:\/\/www.medicalbillersandcoders.com\/blog\/wp-json\/wp\/v2\/posts\/14886\/revisions"}],"predecessor-version":[{"id":29819,"href":"https:\/\/www.medicalbillersandcoders.com\/blog\/wp-json\/wp\/v2\/posts\/14886\/revisions\/29819"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.medicalbillersandcoders.com\/blog\/wp-json\/wp\/v2\/media\/29807"}],"wp:attachment":[{"href":"https:\/\/www.medicalbillersandcoders.com\/blog\/wp-json\/wp\/v2\/media?parent=14886"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.medicalbillersandcoders.com\/blog\/wp-json\/wp\/v2\/categories?post=14886"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.medicalbillersandcoders.com\/blog\/wp-json\/wp\/v2\/tags?post=14886"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}