New codes for responding to portal messages

The 2020 update to the Medicare Physician Fee Schedule includes new codes for digital evaluation and management (E/M) through a secure online platform, such as an electronic health record (EHR) patient portal.

Physicians or other qualified health professionals who perform digital E/M services for a single patient for a total of 5 to 10 minutes within a seven-day period can report CPT code 99421, which carries an approximate Medicare payment of $15.50 in a nonfacility setting. For 11 to 20 minutes they can report code 99422, which carries an approximate payment of $31, and for more than 20 minutes they can report code 99423, for approximately $50.

To bill for these services, the patient must be established (though the problem may be new), the patient must be the one who initiates the services, and the problem must require a physician or other qualified health professional’s evaluation, assessment, and management.

Read the full FPM article: “The 2020 Medicare Documentation, Coding and Payment Update.”

Posted on Jan 23, 2020 by FPM Editors