How to Code for Telehealth, Audio-Only, and Virtual-Digital Visits

Learn how to accurately get paid for telemedicine services with medical codes for telehealth, audio-only, and virtual-digital visits.

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Coding for Telehealth Visits

Note: These tables are informational, not advisory. The AAFP recommends that physicians verify each payer's policy and ask patients to verify their coverage ahead of appointments.

How do I code a new or established patient telehealth office visit that uses audio-video communications technology?

	Aetna	Elevance*	Cigna	Humana	UHC	Medicare
CPT Codes	99202-99205, 99211-99215, 99242-99245 99417, G2212	99202-99205, 99211-99215, 99242-99245, G2212, 99417	99202-99205, 99211-99215, 99417 (accepted for behavioral health services only), G2212	99202-99205, 99211-99215, G2212	99202-99205, 99211-99215, G2212	99202-99205, 99211-99215, G2212
Place of Service (POS)	Commercial: POS 02 or 10 Medicare Advantage: Use POS that would have been used if the service had been provided in person (e.g., POS 11 – Office)	Commercial: 02 or 10 Medicare Advantage: Elevance policy not publicly available. Check with your local provider relations representative	Commercial: POS 02 Medicare Advantage: Use POS that would have been used if the service had been provided in person (e.g., POS 11 – Office)	Commercial: Use POS 02 or 10 Medicare Advantage: Use the POS that would have been used if the service had been provided in person (e.g., POS 11 – Office)	Commercial: POS 02 or 10 Medicare Advantage: 02 or 10	Use POS that would have been used if the service had been provided in person (e.g., POS 11 – Office)
Modifier	Commercial: -GT or -95 Medicare Advantage: -95	Commercial: -95 Medicare Advantage: Elevance policy not publicly available. Check with your local provider relations representative	Commercial:-GQ, -GT, or -95 (all three accepted) Medicare Advantage: -95	Commercial: -95 or GT Medicare Advantage: -95	Commercial:-95, GT, GQ, and G0 optional Medicare Advantage:-95

*Elevance's policies vary by state; contact your provider-relations representative.

Coding for Audio-only Visits

How do I code an audio-only visit for a new or established patient?

CPT Codes: 99441-99443

Aetna

Elevance*

Cigna

Humana

UHC

Medicare

Place of Service (POS)

Commercial: POS 02 or 10

Medicare Advantage: Check with your local provider relations representative

Commercial: POS 02

Medicare Advantage: Use POS used for typical services (e.g., POS 11 – Office)

Commercial: POS 02 or 10

Medicare Advantage: POS 02, 10, or use POS used for typical services (e.g., POS 11 – Office)

UHC does not cover telephone-E/M services. See notes below.

Use POS used for typical services (e.g., POS 11 – Office)

Modifier

-93 or -FQ

Commercial: -93 or -FQ

Medicare Advantage: -95

-93

-93 or -FQ

Audio-only scenario notes

Medicare requires audio-video for most office visit evaluation and management (E/M) services (CPT codes 99202-99215) telehealth services. Audio-only encounters are allowed for certain services. Eligible services may be found on the Medicare Telehealth Services list. Medicare allows audio-only telehealth services for office visit E/M services (CPT codes 99202-99215) for the treatment of mental health conditions.

UHC states they will consider payment for eligible audio-only services listed in Appendix P of the CPT book. Eligible services must be reported using either POS 02 or 10 and include the -93 modifier. CPT codes billed with modifier -93 that are not in Appendix P will not be considered for payment.

Private payers vary on covered telehealth services. Check with your provider relations representatives for each payer’s telehealth policy and covered telehealth services.

CMS will cover telephone evaluation and management (E/M) services (CPT codes 99441-99443) through the end of calendar year 2023. Other services that may be provided via audio-only are available on the Medicare Telehealth List.

Telephone E/M services are provided to a patient, parent, or guardian and do not originate from a related E/M service within the previous seven days and do not lead to an E/M service or procedure within the next 24 hours or soonest available appointment.

The following codes may be used by physicians or other qualified health professionals who may report E/M services:

99441: telephone E/M service; 5-10 minutes of medical discussion
99442: telephone E/M service; 11-20 minutes of medical discussion
99443: telephone E/M service, 21-30 minutes of medical discussion

Telephone E/M services should not be reported when the time spent on the telephone is captured in other services reported, such as:

if CPT codes 99421-99423 have been reported by the same physician in the previous seven days for the same problem,
when CPT codes 99339-99340 and 99374-99380 are used for the same call,
during the same month with CPT codes 99487 and 99489, and
when performed during the same service period at CPT codes 99495-99496.

Self-funded plans can develop their own policies and may opt out of some cost-sharing waivers. Similarly, Medicaid policies are established at the state-level. The AAFP recommends reaching out to your provider relations representatives or Medicare Administrative Contractors (MACs) to verify policies.

Coding for Virtual-Digital Visits

How do I code an e-visit (CPT 99421-99423) for an established patient?

CPT Codes: 99421-99423

Aetna

Elevance*

Cigna

Humana

UHC

Medicare

Place of Service (POS)

Use POS used for typical services (e.g., POS 11 – Office)

Not accepted

Use POS used for typical services (e.g., POS 11 – Office)

Modifier

None

How do I code a virtual check-in (HCPCS codes G2012 and G2010) for an established patient?

HCPCS Codes: G2012, G2252, G2010

Aetna

Elevance

Cigna

Humana

UHC

Medicare

Place of Service (POS)

Use POS used for typical services (e.g., POS 11 – Office)

G2010 only covered in Ohio. Use POS used for typical services (e.g., POS 11 – Office).

G2012, G2252, G2010 not accepted.

Use POS used for typical services (e.g., POS 11 – Office)

 *Does not cover G2252

Use POS used for typical services (e.g., POS 11 – Office)

Modifier

None

Virtual/Digital Scenario Notes

Patient consent is required and may be obtained either before or at the time of service.
Virtual check-ins and e-visits must technically be initiated by a patient; however, physicians and other providers may need to educate beneficiaries on the availability of the service prior to patient initiation.
There are no POS or modifier requirements for virtual check-ins or e-visits. Use the POS used for typical services.
Self-funded plans can develop their own policies and may opt out of some cost-sharing waivers. Similarly, Medicaid policies are established at the state-level. The AAFP recommends reaching out to your provider relations representatives or Medicare Administrative Contractors (MACs) to verify policies.

Virtual Check-in (HCPCS Code G2012, G2252)

These are brief conversations with a physician or other clinician to determine if an in-person visit is necessary.
The communication cannot be related to a medical visit within the previous seven days and cannot lead to medical visit within the next 24 hours (or soonest appointment available).
Physician or other clinician may respond to patient by telephone, audio/video, secure text messaging, email, or patient portal.
HCPCS code G2010 can be used when a captured video or image (store and forward) is sent to the physician. The physician must follow up with the patient within 24 business hours. The consultation must not originate from an evaluation and management (E/M) service provided within the previous seven days or lead to an E/M service within the next 24 hours (or soonest available appointment).

E-Visits (online digital evaluation and management services)

These are non-face-to-face, patient-initiated communications with the physician through an online patient portal. The communications can occur over a seven-day period, and the exchange must be stored permanently.
They are a time-based service. Physicians use the cumulative time for up to seven days to determine the level of service.
- Cumulative time includes review of the initial inquiry, review of patient records pertinent to the assessment of the patient’s problem, personal interaction with clinical staff focused on the patient’s problem, development of management plans (including generation of prescriptions or ordering of tests), and subsequent communication with the patient. Communication can occur through online, telephone, email, or other digitally supported communication

Physicians and other clinicians who may independently bill Medicare for E/M services can use the following codes:

99421: Online digital evaluation and management service, for a patient, for up to 7 days, cumulative time during the 7 days; 5-10 minutes
99422: Online digital evaluation and management service, for a patient, for up to 7 days, cumulative time during the 7 days; 11-20 minutes
99423: Online digital evaluation and management service, for a patient, for up to 7 days, cumulative time during the 7 days; 21 or more minutes

E-visits should not be billed on the same day the physician reports an office visit E/M service (CPT codes 99202-99205 and 99211-99215) for the same patient. Additionally, e-visits should not be billed when using the following codes for the same communication:

99091
99339-99340
99374-99380
99487 and 99489
99495-99466