« Four principles for ... | Main | A checklist for reop... »
Friday May 01, 2020
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
Insightful, quick-read tips delivered straight to your inbox
Sign up to receive FPM's free, weekly e-newsletter, "Quick Tips & Insights," filled with practical, peer-reviewed advice you can put to work right now to improve patient care, streamline your day, get properly reimbursed, and improve career satisfaction.
Posted at 04:45PM May 01, 2020 by FPM Editors
« Four principles for ... | Main | A checklist for reop... »
