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Some patients may not be able to have video visits because they don’t have access to interactive audio-video technology, they may not be facile with technology, or they may just prefer not to use video technology. Practices can use audio-only telephone calls to provide care to their patients if video visits are not possible.
Applicable Regulations and Waivers
For the duration of the public health emergency, CMS and some private payers are allowing audio-only telephone calls to be billed in the same way as in-person visits and these visits will be paid in equivalent amounts as E&M codes 99212-99214. This change is effective April 30, 2020, and is retroactive to March 1, 2020. The following criteria apply to Medicare visits during the emergency.
- Can be used for new or established patients.
- Document verbal consent and why in-person or audio-video encounter was not possible
Billing and Coding
- Use modifier -93 for the reporting of medical services that are provided via real-time interaction between the physician or other qualified health care professional (QHP) and a patient through audio-only technology. The totality of the communication of information exchanged during the course of the service must be of an amount and nature that is sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction. This modifier is effective January 1, 2022.
- Use the normal Place of Service, e.g. POS = 11 for private practice.
- CPT Codes
- 99441 - Medical discussion of 5 to 10 minute duration
- 99442 - Medical discussion of 11 to 20 minute duration
- 99443 - Medical discussion of 21 to 30 minute duration