You are using an outdated browser. Please upgrade your browser to improve your experience.

You are using an outdated browser.

To ensure optimal security, this website will soon be unavailable on this browser. Please upgrade your browser to allow continued use of ACP websites.

You are here

Telehealth Resources

Get a look at ACP’s existing and planned telehealth resources.

Telehealth, or telemedicine, is the use of technology to deliver care at a distance.

ACP supports the expanded role of telemedicine in the primary care setting and has put together the following resources breaking down a physician's telehealth options, the applicable billing codes, and ACP policy guidance.


Telehealth Coverage

Telehealth coverage varies by payer and state. Learn more about state rules and regulations as they apply to your practice and your patients.

Learn More


Telehealth Options, Billing Codes and More

This information is current as of September 2019.

Consider the following guidelines when billing the below codes:

  • Can be any real-time audio (telephone), or "2-way audio interactions that are enhanced with video or other kinds of data transmission."
  • Established patients only.
  • Any chronic patient who needs to be assessed as to whether an office visit is needed. 
  • Patients being treated for opioid and other substance-use disorders.
  • Nurse or other staff member cannot provide this service. It must be a clinician who can bill E&M services.
  • If an E&M service is provided within the defined time frames, then the telehealth visit is bundled in that E&M service. It would be considered pre- or post-visit time of the associated E&M service and thus not separately billable.
  • No geographic restrictions for patient location. 
  • Should be initiated by the patient since a copay is required. Verbal consent to bill and documentation is required.
  • Communication must be HIPAA compliant.
Code Description Fac Fee Non-Fac Fee
G2012 Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report E&M services, provided to an established patient, not originating from a related E&M service provided within the previous 7 days nor leading to an E&M service or procedure withint the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion. $14.78 $13.33

Consider the following guidelines when billing the below codes:

  • Established patients only.
  • Involves "asynchronous transmission of healthcare information" from the patient. If the images are not sufficient to perform the evaluation, then do not bill for the service.
  • If an E&M service is provided within the defined time frames, then the telehealth visit is bundled in that E&M service. It would be considered pre- or post-visit time of the associated E&M service and thus not separately billable.
  • Followup can be by phone, audio/video, secure text messaging, email or patient portal communication.
  • Should be initiated by the patient since a copay is required. Verbal consent to bill and documentation is required.
  • Communication must be HIPAA compliant.
  • This is distinct from CCM code 99490, which can be provided without the patient's presence and use any means of communication.
Code Description Fac Fee Non-Fac Fee
G2010 Remote evaluation of recorded video and/or images submitted by an established patient (e.g. store and forward), including interpretation with followup with the patient within 24 business hours, not originating from a related E&M service provided within the previous 7 days nor leading to an E&M service or procedure within the next 24 hours or soonest available appointment. $9.37 $12.61
99453 Remote monitoring of physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate), initial; set-up and patient education on use of equipment $19.46 $19.46
99454 Remote monitoring of physiologic parameter(s) (eg, weight, BP, pulse oximetry, respiratory flow rate) initial; device(s) supply with daily recording(s) or programmed alert(s) transmission, each 30 days $64.15 $64.15
99457 Remote physiologic monitoring treatment management services, 20 minutes or more of clinical staff, physician, or other qualified health professional time in a calendar month requiring interactive communication with the patient/caregiver during the month $32.44 $51.54

Consider the following guidelines when billing the below codes:

  • These codes are inherently non face-to-face codes.
  • 99446-8 and 99451 are to be used by the specialist.
  • 99452 is only to be used by the requesting clinician.
  • CCM codes are for patients enrolled in that service and clinical staff and care coordinators can conduct those visits. These codes are to be used only by the qualified clinicians.
  • Because cost-sharing will be required, advance verbal consent to bill and documentation is required for each service. (Blanket consent is not allowed.)
CPT Description Fee
99451 Interprofessional telephone/internet/EHR assessment & management service including a written report to the treating/requesting clinician, 5 or more minutes of medical consultative time $37.48
99452 Interprofessional telephone/internet/EHR referral service provided by a treating/requesting clinician, 30 min.  Note: Requesting physician code. $37.48
99446 Interprofessional telephone/internet/EHR assessment & management service provided by a consultative clinician, including a verbal and written report to the treating/requesting clinician, 5-10 minutes of medical consultative discussion and review $18.38
99447 Interprofessional telephone/internet/EHR assessment & management service provided by a consultative clinician, including a verbal and written report to the treating/requesting clinician, 11-20 minutes of medical consultative discussion and review $36.40
99448 Interprofessional telephone/internet/EHR assessment & management service provided by a consultative clinician, including a verbal and written report to the treating/requesting clinician, 21-30 minutes of medical consultative discussion and review $54.75
99449 Interprofessional telephone/internet/EHR assessment & management service provided by a consultative clinician, including a verbal and written report to the treating/requesting clinician, more than 30 minutes of medical consultative discussion and review $72.80

Can I use real-time audio-video technology with my patients?

Is the patient located in my state (or in a state where I am licensed to practice)?

Is the patient located in my state (or in a state where I am licensed to practice)?

Is the patient Medicare?

Is the patient located outside a Metropolitan Statistical Area (MSA) or in a rural Health Professional Shortage Area (HPSA)?

Is the patient located at an allowed "Originating Site"?

Certain facilities are acceptable to serve as the originating site (where the patient is located). This includes:

  • Physician or practitioner office
  • Hospital
  • Critical Access Hospital (CAH)
  • Rural Health Clinic
  • Federally Qualified Health Center (FQHC)
  • Hospital- or CAH-based renal dialysis centers (including satellites)
  • Skilled Nursing Facility (SNF)
  • Community Mental Health Center (CMHC)
  • Renal Dialysis Centers
  • Homes of beneficiaries with ESRD getting home dialysis
  • Mobile Stroke Units

Telehealth Fact Sheet

Are you in an Accountable Care Organization (ACO)?

Some ACOs have a waiver that allows their participants to use telehealth. Check with your ACO to find out the rules regarding telehealth services.

Do Medicaid, Private, and Other Payers allow telehealth?

Check with all applicable payers. Some will pay, all will have their own rules.

An ABN may be needed for Medicare patients

You are ready to begin billing for telehealth services with your patients.

Only certain services are allowed to be billed using telehealth. In general, documentation rules are the same as for face-to-face visits. Use POS=02 and append the allowed CPT code using the correct modifier.

Telehealth codes and modifiers (.XLSX download)

Telehealth is allowed for CCM patients, but if billed separately, the time cannot count toward the CCM monthly time.

Stop. Telehealth is not an option for this patient. However, self-pay may be an option if the patient wants to pay for the service out of pocket.

The spreadsheet below provides a list of CPT codes for which Place of Service=02 (telehealth). For a complete list of services, see this CMS Telehealth Services Fact Sheet. It is important to check with private payers for their allowed codes.

Additionally, it is important to contact your payers before billing these codes using these modifiers. Some payers may have their own rules on how to bill and which codes or which conditions are covered.  

Beginning July 1, 2019: For substance (including opioids) use disorder or a co-occurring mental health disorder, the patient’s home is acceptable as an originating site and the patient doesn’t have to meet the other Medicare requirements of being outside an MSA, etc.  

Telehealth Codes

The ‘originating site’ refers to the location of the Medicare beneficiary (the patient). The ‘distant site’ refers to the location of the eligible clinician. For the telehealth service to be covered under Medicare, the patient needs to be located at one of the following qualified locations or facilities:

  • Physician or practitioner office
  • Hospital
  • Critical Access Hospital (CAH)
  • Rural Health Clinic (RHC)
  • Federally Qualified Health Center (FQHC)
  • Hospital- or CAH-based renal dialysis centers (including satellites)
  • Skilled Nursing Facility (SNF)
  • Community Mental Health Center (CMHC)
  • Renal Dialysis Centers
  • Homes of benficiaries with ESRD getting home dialysis
  • Mobile Stroke Units

Medicare does not apply originating site geographic conditions to hospital-based and CAH-based renal dialysis centers, renal dialysis facilities, and beneficiary homes when practitioners furnish monthly home dialysis ESRD-related medical evaluations. Independent Renal Dialysis Facilities are not eligible originating sites.

Beginning January 1, 2019, the Bipartisan Budget Act of 2018 removed the originating site geographic conditions and added eligible originating sites to diagnose, evaluate, or treat symptoms of an acute stroke.

Originating sites may bill the following code:

Q3014 - Telemedicine originating site facility fee. Used only by the allowed designated facility where the patient is located. Cannot be used when the patient is at home.


Is Telehealth Feasible For Your Practice?

Use this spreadsheet calculator to conduct a cost-benefit analysis to help you determine whether adding telehealth will be financially feasible.

Cost/Benefit Analysis


More on Telehealth

Telehealth Coverage

Telehealth coverage and regulations vary by payer and state. Below are links to coverage rules for some of the major payers. Because policies related to technology and telehealth are changing, it is important to check with your payers regarding any rule changes.

Please note that several payers require that patients use Teledoc, American Well, or MDLive for virtual visits (both acute care and behavioral health). These services will send a report of the visit via fax, but only if the patient provides their primary care doctor’s fax number, so it is important to educate your patients who choose to use these services on the importance of getting any visit information, including medications prescribed, to your office. Patients need to know that they have to request this to happen.

  • Aetna    
  • Anthem    
  • Cigna (America Well or MDLive, depending on the plan)
  • FEP Blue (Uses Teledoc.  Please educate your patients to provide your office fax number so that the records of virtual visits can be provided to your office)
  • Humana (Rules vary by plan)
  • Medicaid
  • United
More State-Specific Information