The remaining 16 new telemedicine CPT codes will appear on the Medicare Physician Fee Schedule with a status indicator of I, which means they will not be covered codes for Medicare beneficiaries. This does not mean the codes are inactive or invalid; Medicare has indicated that it has G codes that represent the services for CPT codes 98000–98015, making it unnecessary to cover both sets of codes.
Additionally, Medicare will allow use of audio-only communication technology for any telehealth service provided to a patient in their home if the physician can use an audio-video telecommunications system but the patient is unable or does not consent to use of video. The CMS has also stated the following elements will be necessary when billing for audio-only services:
- Documentation must reflect that the physician has audio-video available, but the patient preferred audio-only or was unable to use audio-video; and
- The provider must append CPT modifier 93 to services provided via audio-only.
- Federally qualified health centers and rural health centers should use modifier FQ, 93 or both where appropriate because they are identical in meaning.
When providing telemedicine services, providers should use the CPT or HCPCS code that best describes the service provided to avoid denials and payment adjustments. Contact the ACR practice management team for any questions or additional information at [email protected].
ACR Lunch & Learn Series
The ACR practice management team offers a free, tailored, one-hour lunch-and-learn series on coding and compliance to ensure billing accuracy for rheumatology services. This workshop will give hands-on training to help rheumatology practices maximize reimbursements and minimize claim denials or rejections. It will also provide key insights on navigating documentation and coding challenges.
The webinar is the latest in a series of resources developed to assist members, practices, and their staff with coding updates. To schedule a lunch-and-learn training session, contact Melesia Tillman at [email protected]. For additional questions on billing and coding for telemedicine and other E/M services contact the ACR practice management department at [email protected].
