• Two welcome changes for audio-only telephone visits

    On April 30, the Centers for Medicare & Medicaid Services (CMS) issued another round of regulatory changes 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.

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

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

    Posted on May 01, 2020 by FPM Editors

    Disclaimer: The opinions and views expressed here are those of the authors and do not necessarily represent or reflect the opinions and views of the American Academy of Family Physicians. This blog is not intended to provide medical, financial, or legal advice. All comments are moderated and will be removed if they violate our Terms of Use.