Don’t expect to see payment any time soon for ‘telephone consults’

by  Codapedia
January 6th, 2016

By: Scott Kraft (Oct/15/2014) 

Four new CPT® codes that got some attention when the 2014 CPT® changes were released late last year were a new E/M code series, 99446-99449, designed to be reported when a consulting provider offered a telephone or Internet E/M service that included a verbal and written report back to the patient’s requesting physician.

The delivery of physician services may be getting close to a technology tipping point – after all, a recent Information Week report suggests even telemedicine will be a $27 billion business by 2016. 

But these new codes are likely to be another instances where the technology – and the availability of the codes for billing and tracking – is ahead of the world of payment. So far, Medicare slapped the new codes with a payment status indicator of B – making them bundled into all other services – and there is no evidence that any other payers see them any differently.

It’s unclear whether the time spent on these service could truly be “bundled” into a face-to-face encounter, given Medicare’s refusal to pay for non face-to-face care. At least not yet.

The four codes are based on the amount of time spent on the service, and are intended for use by the provider being consulted. 99446 is for between 5-10 minutes of time, 99447 for 11-20 minutes, 99448 for 21-30 minutes and 99449 for more than 31 minutes. 

The time counted toward the services are medical consultative discussion and review time spent by the specialist. These new codes are different from the 99441-99444 set created in 2008 for phone or Internet E/M services with the patient because they are intended to cover discussions between providers.

If a payer allows you to bill these codes, or to consider the time spent as part of a bundle into a different E/M face-to-face encounter, remember these rules that govern their use:

References:

Don’t expect to see payment any time soon for ‘telephone consults’. (2016, January 6). Find-A-Code Articles. Retrieved from https://www.findacode.com/articles/don-t-expect-to-see-payment-any-time-soon-for-telephone-consults-28044.html

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