Table 3.

Suggested Billing Codes for Telemedicine Use Based on Advice of American Medical Association

Telehealth Billing/Documentation Requirements Updated 5/4/2020
Type of Visit/Treatment	Performed by	SARS-CoV-2–Focused ICD-10-CM Codes	CPT Codes	Place of Service
In-office E/M visit	Physician/QHP	Asymptomatic: Z11.59 No exposure to SARS-CoV-2: 03.818 Contact with SARS-CoV-2, suspected exposure: Z20.828	New: 99201-99205 Established: 99212-99215 Consult: 99241-99245	11 physician office; 19 off campus outpatient hospital; 20 urgent care facility; 22 on campus outpatient hospital
Patient swab sample collection	Clinical staff	Asymptomatic: Z11.59; no exposure to SARS-CoV-2: Z03.818; Contact with SARS-CoV-2, suspected exposure: Z20.828	Swab collection included in E/M: 99000	NA
SARS-CoV-2 test performed	Est Mychart Telehealth/Mychart telehealth	Asymptomatic: Z11.59; no exposure to SARS-CoV-2: Z03.818; contact with SARS-CoV-2, suspected exposure: Z20.828	87635	19 off campus outpatient hospital; 22 on campus outpatient hospital; 81 independent laboratory
Patient evaluated for SARS-CoV-2 testing need by E/M telehealth	Physician/QHP	Asymptomatic: Z11.59; no exposure to SARS-CoV-2: Z03.818; contact with SARS-CoV-2, suspected exposure: Z20.828	New patient: 99201 (typical time 10 min). 99202 (typical time 20 min), 99203 (typical time 30 min), 99204 (typical time 45 min), 99205 (typical time 60 min) Current patient: 99212 (typical time 10 min), 99213 (typical time 15 min), 99214 (typical time 25 min), 99215 (typical time 40 min)	11 physician office; 19 off campus outpatient hospital; 20 urgent care facility; 22 on campus outpatient hospital
Patient evaluated for SARS-CoV-2 testing need: online	Physician/QHP	Asymptomatic: Z11.59; no exposure to SARS-CoV-2: Z03.818; contact with SARS-CoV-2, suspected exposure: Z20.828	New or established patient: 99421 (5-10 min), 99422 (11-20 min), 99423 (≥21 min); payor guidelines may vary; G2010 Remote image: G2012 virtual check-in	11 physician office
Patient setup and education on Telehealth services	Physician/QHP/clinical staff	NA	99453: remote monitoring of physiologic parameter(s)	11 physician office
Remote physiologic monitoring treatment (first 20 min)	Physician/QHP	NA	99457: remote physiologic monitoring treatment management, first 20 min	11 physician office
Remote physiologic monitoring treatment (each additional 20 min)	Physician/QHP	NA	99458: remote physiologic monitoring treatment management, each additional 20 min	11 physician office
Collection and interpretation of physiologic data digitally stored and/or transmitted by patient	Physician/QHP	NA	99091: collection and interpretation of physiologic data	11 physician office
Telehealth visit emergency department	Physician/QHP		99281 (self-limited or minor); 99282 (low to moderate severity); 99283 (moderate severity); 99284 (high severity, no immediate significant threat to life or physiologic function); 99285 (high severity, immediate significant threat to life or physiologic function)	23 physician office

Abbreviations: CPT, Current Procedural Terminology; E/M, evaluation and management; ICD-10-CM, International Classification of Diseases, Tenth Revision, Clinical Modification; N/A, not available; QHP, qualified health plan; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2.

Information adapted from Special Coding Advice During COVID-19 Public Health Emergency. American Medical Association; May 4, 2020.¹⁶