Two welcome changes for audio-only telephone visits

On April 30, the Centers for Medicare & Medicaid Services (CMS) issued another round of regulatory changes(www.cms.gov) to expand access to care during the COVID-19 public health emergency. One of the key changes was making Medicare payments for audio-only telephone evaluation and management (E/M) visits (CPT codes 99441-99443) equal to payments for comparable office or outpatient visits with established patients (codes 99212-99214). The range of payments will increase from about $14-$41 to about $46-$110, with the changes retroactive to March 1.

CMS also broadened the list of services it will cover as audio-only telephone visits. Noting that some Medicare beneficiaries do not have access to the interactive audio-video technology required for Medicare telehealth services, or choose not to use it, CMS is waiving the video requirement for certain services and adding them to the list of Medicare-covered telehealth services. As a result, Medicare beneficiaries will now be able to use audio-only telephone visits to receive annual wellness visits (G0438-G0439), advance care planning (99497-99498), tobacco and smoking cessation counseling (99406-99407), and many behavioral health and patient education services. See a partial list of covered services below, or download the full list from CMS(www.cms.gov).

CMS has not yet released guidance regarding whether practices will need to rebill affected claims. FPM will post updates as more details are released.

CPT/HCPCS code	Description	RVUs	In-person	Audio and video	Audio only
CPT/HCPCS code: 99201-99215	Description: New and established patient office visits (E/M)	RVUs: 0.18-3.17	In-person: Yes	Audio and video: Yes	Audio only: No
CPT/HCPCS code: 99441-99443	Description: Telephone E/M services	RVUs: 0.48-1.5	In-person: No	Audio and video: No	Audio only: Yes
CPT/HCPCS code: G0296	Description: Counseling to discuss need or LDCT for lung cancer screening	RVUs: 0.52	In-person: Yes	Audio and video: Yes	Audio only: Yes
CPT/HCPCS code: G0402	Description: Welcome to Medicare - Initial Preventive Physical Exam (IPPE)	RVUs: 2.43	In-person: Yes	Audio and video: No	Audio only: No
CPT/HCPCS code: G0438	Description: Annual wellness visit, includes PPPS, first visit	RVUs: 2.43	In-person: Yes	Audio and video: Yes	Audio only: Yes
CPT/HCPCS code: G0439	Description: Annual wellness visit, includes PPPS, subsequent visit	RVUs: 1.5	In-person: Yes	Audio and video: Yes	Audio only: Yes
CPT/HCPCS code: 99495-99496	Description: Transitional care management (moderate and high MDM)	RVUs: 2.36-3.1	In-person: Yes	Audio and video: Yes	Audio only: No
CPT/HCPCS code: 99497-99498	Description: Advance care planning	RVUs: 1.5/1.4	In-person: Yes	Audio and video: Yes	Audio only: Yes
CPT/HCPCS code: 99406-99407	Description: Smoking and tobacco cessation counseling	RVUs: 0.24/0.50	In-person: Yes	Audio and video: Yes	Audio only: Yes
CPT/HCPCS code: 99354-99355	Description: Prolonged E/M or psychotherapy service, beyond the typical time, direct patient contact	RVUs: 2.33/1.17	In-person: Yes	Audio and video: Yes	Audio only: Yes
CPT/HCPCS code: G0513-G0514	Description: Prolonged preventive services, beyond the typical time, direct patient contact	RVUs: 1.17	In-person: Yes	Audio and video: Yes	Audio only: Yes
CPT/HCPCS code: G0442	Description: Annual alcohol misuse screening	RVUs: 0.18	In-person: Yes	Audio and video: Yes	Audio only: Yes
CPT/HCPCS code: G0443	Description: Brief face-to-face counseling for alcohol misuse, four per year for those who screen positive	RVUs: 0.45	In-person: Yes	Audio and video: Yes	Audio only: Yes
CPT/HCPCS code: G0444	Description: Annual depression screening	RVUs: 0.18	In-person: Yes	Audio and video: Yes	Audio only: Yes
CPT/HCPCS code: G0445	Description: High-intensity behavioral counseling to prevent STI, face-to-face, individual	RVUs: 0.45	In-person: Yes	Audio and video: Yes	Audio only: Yes
CPT/HCPCS code: G0446	Description: Intensive behavioral therapy to reduce cardiovascular disease risk, face-to-face, individual, biannual	RVUs: 0.45	In-person: Yes	Audio and video: Yes	Audio only: Yes
CPT/HCPCS code: G0447	Description: Face-to-face behavioral counseling for obesity	RVUs: 0.45	In-person: Yes	Audio and video: Yes	Audio only: Yes

Source: List of codes compiled by Vinita Magoon, DO, JD, MBA, MPH, CMQ

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Posted at 04:45PM May 01, 2020 by FPM Editors

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