CMS Now Reimburses Telephone E/M Visits on Par with Office Visits

CMS has recently announced updates to its reimbursement strategy to further accomodate physicians who are providing remote care due to the coronavirus outbreak. A broad range of clinicians, including physicians, can now provide certain services bytelephone to their patients. These changes are retroactive to services provided since March 1.

According to CMS' published guidelines:

Medicare payment for the telephone evaluation and management visits (CPT codes99441-99443) is equivalent to the Medicare payment for office/outpatient visits with established patients effective March 1, 2020.

When clinicians are furnishing an evaluation and management (E/M) service that wouldotherwise be reported as an ...



In our continuing effort to simplify the information being distributed by top insurers during this pandemic regarding their current adjusted billing rules, we are providing this summary. It contains information taken directly from each insurer’s website, augmented by our telephone conversations with representatives of the various companies. Additionally, for further clarity we are providing links to the most complete explanations each payer has distributed to date. We have highlighted certain points in bold to facilitate your ability to quickly review the information. We must caution this is a guide based on the most current information available to us.

Please reach out to us if you are...


Breaking News: CMS Allows E/M Codes to be Billed for Telephone Visits During Covid-19 Outbreak

Here is the latest information, simplified. Click here to view the CMS Medicare Telemedicine Health Care Provider Fact Sheet

Understanding the Difference Between Telemedicine, Telehealth, Virtual Check-ins, E-visits

  • Telemedicine is audio only (99441-3) based on time see attached – established patients only

  • Telehealth is audio AND video (99201-99215 new and established patient E/M). Audio could be anything from Skype to Zoom to to iChat etc.

  • Virtual check-in is audio - CMS only (G2012) established patients only

  • E-visit is online (99421-3 for MD & G2061-3 for non-MD, qualified professional)

  • Modifier to use for any of the above is 95 and place of service is 02

  • Document consent of pati...


Can I Bill for Telephone Consults?

As social isolation becomes a reality for increasing numbers of us, many physicians are wondering whether telephone check-ins are reimbursable by private payers, Medicare and Medicaid.

While commercial carriers have been reluctant to reimburse for telephone check-ins in the past, more recently both Medicaid and some private carriers have indicated that they will reimburse for these virtual visits. Here at E Central Medical Management, we are tracking carriers and gathering data so that we can confidently advise our clients on whether or not these claims are actually being honored.

Medicaid and Commercial Carriers

CPT offers codes to report telephone services provided by a physician or other qua...