Coming soon: Medicare payment for virtual encounters

Coding changes for 2019 offer new opportunities to get paid for several types of virtual encounters.

These new HCPCS codes offer payment for virtual encounters with Medicare patients:

• G2012, Brief communication technology-based service, e.g., virtual check-in, by a physician or other qualified health care professional who can report E/M services, provided to an established patient, with five to 10 minutes of medical discussion. The service must not originate from a related E/M service provided within the previous seven days nor lead to an E/M service or procedure within the next 24 hours or until the soonest available appointment.

• G2010, Remote evaluation of recorded video or images submitted by an established patient (e.g., store and forward), including interpretation and follow-up with the patient within 24 business hours. The service must not originate from a related E/M service provided within the previous seven days nor lead to an E/M service or procedure within the next 24 hours or until the soonest available appointment.

No verbal consultation is required for billing these new interprofessional consult codes, which Medicare has priced for payment in the office setting:

• CPT 99451, Interprofessional telephone/internet/electronic health record assessment and management service provided by a consultative physician, including a written report to the patient’s treating/requesting physician or other qualified health care professional, 5 minutes or more of medical consultative time.

• CPT 99452, Interprofessional telephone/Internet/electronic health record referral service(s) provided by a treating/requesting physician or other qualified health care professional, 30 minutes.

Contact your private payers to learn whether they will pay for these codes as well.

These are just some of the coding changes resulting from the 2019 Medicare Physician Fee Schedule, which also eases some documentation requirements and describes Quality Payment Program developments.

Read the full FPM article, available online ahead of print: “The 2019 Medicare Documentation, Coding, and Payment Update.”