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  • Billing audio only visits primary care

    Thought I was clear on all the telehealth billing rules by now; however, corporate ran an “audit” on our charts last wk and said audio only visits needed to be billed based on time. So 99212 10-19min, 99213 20-29min , 99214 30-39min etc...previously in may 2020 we had reviewed cms telehealth Guidelines with our local biller and agreed that cms was allowing audio only visits to be billed based on medical decision making OR time. Can someone clear the air on this??

  • #2
    Audio only uses different cpt codes:
    99441 5-10 min
    99442 11-20 min
    99443 21+ min
    Some of our payers ended coverage in February another March and another will in June, initially they were to all end October 1.

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    • #3
      Originally posted by DocNextDoor View Post
      Audio only uses different cpt codes:
      99441 5-10 min
      99442 11-20 min
      99443 21+ min
      Some of our payers ended coverage in February another March and another will in June, initially they were to all end October 1.
      Yes, this. Many of our payers will be done covering telehealth services soon.

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      • #4
        Our phone visits pay crap. Telehealth with video is similar to in office visits.

        The only reason for requiring video is to make it harder to bill more. How much is really gained by "seeing" them? I had this discussion with a group of docs who went on about seeing their living situations and facial expressions, blah blah

        Of course there is select cases where video would help. But I submit to you that 95% of what can be done by video can be done easier on the phone.

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        • #5
          Originally posted by Lordosis View Post
          Our phone visits pay crap. Telehealth with video is similar to in office visits.

          The only reason for requiring video is to make it harder to bill more. How much is really gained by "seeing" them? I had this discussion with a group of docs who went on about seeing their living situations and facial expressions, blah blah

          Of course there is select cases where video would help. But I submit to you that 95% of what can be done by video can be done easier on the phone.
          as a patient i like audio option better as well.

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          • #6
            I can not confirm but was told: If a patient does not have video capabilities and you otherwise would have done telehealth you can document this and bill an audio only visit as telehealth...

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            • #7
              I think the rules between the two are that with telehealth , it must be billed by a time component only, and video visit can be billed using either time or complexity which follows similar guidelines to in person visits with the new coding guidelines for 2021. Either should be billed with a modifier which delineates whether it was related directly to covid or ordering a covid related test , because several insurances, at least were waiving any cost share for that component, ie deductible, copay or coinsurance. Prescription management increases the E&M code with normal guidelines and video , but not with telephone consultation only.

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              • #8
                Originally posted by Lordosis View Post
                Our phone visits pay crap. Telehealth with video is similar to in office visits.

                The only reason for requiring video is to make it harder to bill more. How much is really gained by "seeing" them? I had this discussion with a group of docs who went on about seeing their living situations and facial expressions, blah blah

                Of course there is select cases where video would help. But I submit to you that 95% of what can be done by video can be done easier on the phone.
                My patients and I both prefer phone visits. It's too bad we probably won't be able to do them much longer. Agree you don't get much more info from seeing them visually.

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