A Guide To Telehealth CPT Codes in 2021

artwork depiecting a female healthcare professional reading over CPT codes.
telehealth cpt codes

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  

[2]https://www.gastroendonews.com/In-the-News/Article/05-21/E-M-Coding-for-2021-What-s-New-and-Different-/63426 




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