A Guide To Telehealth CPT Codes in 2021
- John Carmody
- 0
- on Nov 16, 2021
Current Procedural Terminology (CPT) codes offer healthcare professionals a uniform coding language to streamline reporting and billing for medical services. If you’re a physician who is using telehealth or you are considering telehealth, it’s important to learn how CPT codes apply to telehealth and how they’re used as part of the telehealth billing process, so you can receive timely reimbursement for services rendered.
However, CPT codes can be a challenging and confusing topic, especially when it comes to telehealth. CPT codes change from year to year. In this article, we will take a closer look at CPT codes and explain the most important CPT code changes of 2021 as they pertain to telehealth.
What are CPT Codes?
As stated above CPT codes are medical code sets used to streamline billing for medical services to entities such as hospitals, private practices, and health insurance companies.
The CPT code system was first developed by the American Medical Association to create a clear, concise, and streamlined billing system for medical service reimbursement.
The Largest Overhaul To CPT Codes In Over 25 Years
On September 1, 2020, The American Medical Association announced the first major overhaul in more than 25 years to outpatient evaluation and management services (E/M) in the 2021 release of Current Procedural Terminology (CPT) code set.[1]
This major overhaul is meant to simplify documentation so that physicians and care teams can be freed from unnecessary administrative burdens.
The 2021 CPT code system revised E/M codes to include 329 editorial changes, 206 new codes, 54 deletions, and 69 revisions.
What Does This Mean For Telehealth CPT Codes?
Well, since telehealth services technically fall under outpatient evaluation and management (E/M), telehealth CPT codes will be affected by these revisions.
Which Codes Are Affected?
- Codes related to prolonged services and proposed new G code which applies to prolonged “virtual check-in services”.
- Codes 99201 to 99215 have changed with the deletion of 99201 because of low usage and the near identical application of code 99202.[2]
Overview of the Most Common Telehealth CPT Codes During COVID-19
|
New Patient |
Established Patient |
||||
|
CPT |
MDM |
2021 Time Range |
CPT |
MDM |
2021 Time Range |
|
99202 |
Straightforward |
15-29 minutes |
99212 |
Straightforward |
10-19 minutes |
|
99203 |
Low Complexity |
30-44 minutes |
99213 |
Low Complexity |
20-29 minutes |
|
99204 |
Moderate Complexity |
45-59 minutes |
99214 |
Moderate Complexity |
30-39 minutes |
|
99205 |
High Complexity |
60-74 minutes |
99215 |
High Complexity |
40-54 minutes |
Virtual Check-in Coding
|
G2010 |
Remote evaluation of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours |
|
G2012 |
Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related E/M service provided within the previous 7 days |
|
G2252 |
11-20 minutes of medical discussion |
Virtual Check-in Medicare Reimbursement Guidelines
|
Virtual Check-ins |
||
|
CPT |
Time |
2021 Medicare Payment |
|
G2010 |
N/A |
$12.21 |
|
G2012 |
5-10 minutes |
$14.66 |
|
G2252 |
11-20 minutes |
$26.87 |
Beam Simplifies
At Beam, we understand that medical billing can be confusing enough but with the advent of telehealth CPT codes medical billing has become much more complicated. As experts in telehealth, our knowledgeable specialists will be more than happy to make themselves indispensable to your practice to advise you on any billing concerns. To learn more about how Beam can help you grow your telehealth practice, click here!
Sources:
[1]https://www.ama-assn.org/press-center/press-releases/ama-releases-2021-cpt-code-set