April 30, 2020
Can we bill telephone only (99441-99443) calls subsequently during the week (or the same day) for the same patient by the same provider or another provider of the same specialty within the practice if each call is documented properly?
The following information is only for guidance during the current COVID-19 public health emergency. According to the CPT Assistant, telephone E/M visits:
- can only be billed once every 7 days by a single provider or other providers of the same specialty within the same practice (meaning you can bill the telephone call code once per practice per week with providers of same specialty)
- can only include time for the billing provider (performing provider(s) if more than one of the same specialty in the same group practice), not staff time on calls
- cannot be billed during the post-op global period for a related issue to any procedure/surgery performed
- can be billed during the post-op global period for an unrelated issue (not a complication) to the procedure or surgery performed (with modifier 24)
- cannot be billed in conjunction with anticoagulant management codes 99363 and 99364 if the call is about warfarin management
- cannot be billed “with the domiciliary, rest home, or home care plan oversight services codes (99339-99340) or the care plan oversight services codes (99374-99380) if the call time is used in reporting the care plan oversight service”
For multiple phone calls during the same day with the same patient, you can aggregate the minutes for the calls and bill ONE telephone call code IF ALL of the following criteria are met:
- Time calculated is only the time the billing provider is talking to the patient, not nurse or staff time talking to the patient.
- Time in exact minutes is documented in the chart for EACH call.
- Documentation for each call indicates what was discussed, changed, or added to the plan of care and reason why (if known) for multiple calls (patient is confused, etc.).
- Remember – medical necessity for billing any service to Medicare or other payors is based on medical necessity.
For multiple phone calls during a 7 day period with the same patient, you would aggregate the minutes for the calls and bill ONE telephone call code if all the above criteria are met.
*This response is based on the best information available as of 04/30/20.