Telehealth Updates

More Pay

Medicare released another round of telehealth updates last week. The good news: they’re increasing pay! The reimbursement for the telephone-only 99441 – 99443 CPT codes increased from $14-$41 to $46-$110. This update is retroactive to March 1st, 2020. These codes represent 5-10 minutes, 11-20 minutes, and 21-30 minutes respectively. The description of this code is:

“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; ____ minutes of medical discussion”

99441 – 99443 are for audio-only visits. Visits that use both audio and video should be billed using standard E&M codes. United Healthcare and Cigna are the two exceptions to this rule. You can bill standard E&M codes for United Healthcare and Cigna if you talk to a patient using audio-only. We recommend you stop using 99421 – 99423 and use the 9441 – 99443 codes instead.

More information on billing telehealth in the EMR can be found below.

We are optimistic that commercial payers will follow Medicare’s guidance and also increase their rates.

But… Still Chaos

Aetna released a statement acknowledging that they paid many telehealth claims incorrectly and will do a full claim review. We are certain other payors have similar issues. Their claims systems were frantically updated for COVID-19. This creates a mess that will leave providers underpaid and patients with incorrect bills. Our proprietary billing software enables us to keep a close eye on every claim and resubmit them in mass. We have a dataset of over 14,000 telehealth claims that we review daily. We are obsessed with the alchemy of turning your claims to revenue.

How to Bill Telehealth in the EMR

  • Document patient consent. We put buttons in your chief complaint for this.

  • Document the time spent. This is necessary to justify the level of service. We added buttons to your plan for this.

  • Make sure you send the ‘TELEH’ CPT. Our team needs this to know it is a telehealth visit. If you use our consent buttons, this gets billed automatically. If not, just hit this button on your superbill when you do your billing.