May 27, 2021

Question:
My doctors are providing telehealth office visits using audio only. They have told me it is okay to use E/M codes 99202-99215 for telephone visits. I was reading the temporary guidelines for Telehealth during the PHE and cannot verify these are the right codes. Can you help?

Answer:
When the telehealth visit is audio only, the practitioner cannot use CPT codes 99202-99205. These codes are used only when audio and video are used for the visit. They can however use CPT codes 99441-99443 with Modifier CR

• 99441-Telephone evaluation and management service by a physician or other qualified health care professional who may report evaluation and management services provided to an established patient, parent, or guardian 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; 5-10 minutes of medical discussion
• 99442-11-20 minutes of medical discussion
• 99443-21-30 minutes of medical discussion

These are time-based codes for audio only telehealth visits that have been temporarily approved by CMS during the public health emergency. For all other payors, you will need to check to find out if they are following CMS guidelines or if they have developed their own standards for telehealth visit coverage. Just make sure to document the exact number of minutes spent with the patient in the medical record, along with the visit summary. As always medical necessity is the driving force behind all visits, and this should be reflected in the medical record. Also keep in mind that the patient’s verbal consent must be documented, and the patient encounter must support medical necessity.

*This response is based on the best information available as of 05/27/21