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
|99201-99215||New and established patient office visits (E/M)
|99441-99443||Telephone E/M services||0.48-1.5||No||No||Yes|
|G0296||Counseling to discuss need or LDCT for lung cancer screening
|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
|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
|99354-99355||Prolonged E/M or psychotherapy service, beyond the typical time, direct patient contact
|G0513-G0514||Prolonged preventive services, beyond the typical time, direct patient contact
|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
|G0444||Annual depression screening||0.18||Yes||Yes||Yes|
|G0445||High-intensity behavioral counseling to prevent STI, face-to-face, individual
|G0446||Intensive behavioral therapy to reduce cardiovascular disease risk, face-to-face, individual, biannual
|G0447||Face-to-face behavioral counseling for obesity
Source: List of codes compiled by Vinita Magoon, DO, JD, MBA, MPH, CMQ
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