Table 1.
CPT Code | Minutes | History | Medical Decision-Making | Patient Type | Visit Type |
---|---|---|---|---|---|
99201 | 10 | Problem focused | Straightforward | New | Videophone∗ |
99202 | 20 | Expanded-problem focused | Straightforward | New | Video phone∗ |
99203 | 30 | Detailed | Low complexity | New | Video phone∗ |
99204 | 45 | Comprehensive | Moderate complexity | New | Video phone∗ |
99205 | 60 | Comprehensive | High complexity | New | Video phone∗ |
99212 | 10 | Problem focused | Straightforward | Established | Video phone∗ |
99213 | 15 | Expanded-problem focused | Low complexity | Established | Video phone∗ |
99214 | 25 | Detailed | Moderate complexity | Established | Video phone∗ |
99215 | 40 | Comprehensive | High complexity | Established | Video phone∗ |
99441 | 1–10 | NA | NA | All | Phone† |
99442 | 11–20 | NA | NA | All | Phone† |
99443 | > 21 | NA | NA | All | Phone† |
CMS = Current Procedural Terminology; NA = not applicable.
Most commercial payers are reimbursing traditional Evaluation and Management codes regardless of telehealth visit type. Modifier 95 is used to denote use of telehealth.
Even though CMS is reimbursing telephone visits with near-parity to video visits, CMS requires telephone visits be coded uniquely as such.