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telemedicine [2025/01/29 15:47] Scott Larsontelemedicine [2025/04/18 20:40] (current) – external edit 127.0.0.1
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 ====== Telemedicine ====== ====== Telemedicine ======
-==== E&M Coding ====+  * Codes describe real-time, interactive encounters between physician or other QHP and patient. 
 +  * Based on level of MDM or total time for E/M performed on date of encounter. 
 +  * Not used for routine telecommunications related to a previous encounter (eg, to communicate lab results). 
 +  * May be used for follow-up of previous encounter when follow-up is required. 
 +  * Medicare allows audio only when the practitioner is audio-video capable, but the patient declines or is unable to use video. This should be clearly documented in the medical record.  
 +  * Time being used for any E/M service should not be counted towards any separately billable service. (e.g. chronic care management or principal care management that accrues over a 30-day period)  
 + 
 +==== Audio-Video Calls ====
 ^New Patient Code^Description^ ^New Patient Code^Description^
 |98000|**Synchronous audio-video visit** for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using total time on the date of the encounter for code selection, __15 minutes must be met or exceeded.__| |98000|**Synchronous audio-video visit** for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using total time on the date of the encounter for code selection, __15 minutes must be met or exceeded.__|
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 For encounters 55+ minutes add code 99417 For encounters 55+ minutes add code 99417
  
 +==== Audio Only Calls ====
 +^New Patient Code^Description^
 +|98008|**Synchronous audio-only visit** for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using total time on the date of the encounter for code selection, __15 minutes must be met or exceeded.__|
 +|98009|**Synchronous audio-only visit** for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low medical decision making. When using total time on the date of the encounter for code selection, __30 minutes must be met or exceeded.__|
 +|98010|**Synchronous audio-only visit** for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate medical decision making. When using total time on the date of the encounter for code selection, __45 minutes must be met or exceeded__.|
 +|98011|**Synchronous audio-only visit** for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high medical decision making. When using total time on the date of the encounter for code selection, __60 minutes must be met or exceeded__. |
 +For service that exceeds 74 minutes add code 99417
  
 +^Established Pt Code^Descriptionj^ 
 +|980012|**Synchronous audio-only visit** for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using total time on the date of the encounter for code selection, __10 minutes must be met or exceeded__.| 
 +|98013|**Synchronous audio-only visit** for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low medical decision making. When using total time on the date of the encounter for code selection, __20 minutes must be met or exceeded__.| 
 +|98014|**Synchronous audio-only visit** for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate medical decision making. When using total time on the date of the encounter for code selection, __30 minutes must be met or exceeded__.| 
 +|98015|**Synchronous audio-only visit** for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high medical decision making. When using total time on the date of the encounter for code selection, __40 minutes must be met or exceeded__.| 
 +For encounters 55+ minutes add code 99417