The Centers for Medicare & Medicaid Services (CMS) made many changes to adapt patient care amid the COVID-19 pandemic. Expanding Medicare coverage to include a range of services through audio-only telehealth visits is one of them.

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Billing for Audio-only Telehealth
The Centers for Medicare & Medicaid Services (CMS) made many changes to adapt patient
care amid the COVID-19 pandemic. Expanding Medicare coverage to include a range of
services through audio-only telehealth visits is one of them.
Let’s understand some of the basic coding guidelines for audio-only
telephone visits:
CPT Code 99441-99443
Code Description
 99441: Telephone evaluation and management service by a physician or other qualified
health care professional who may report evaluation and management services provided to
an established patient, parent, or guardian not originating from a related E/M service
provided within the previous 7 days nor leading to an E/M service or procedure within the
next 24 hours or soonest available appointment; 5-10 minutes of medical discussion.
 99442: 11-20 minutes of medical discussion
 99443: 21-30 minutes of medical discussion

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Basic Guidelines for 99441-99443
 Physicians, nurse practitioners, clinical nurse specialists, certified nurse-midwives and
physician assistants use these CPT codes.
 Audio-only telephone visits were previously had a status indicator as non-covered services
but now CMS will pay for phone calls using codes 99441-99443.
 In most of the cases for 99441-99443, the place of service would be office (11) or outpatient
department (19, 22).
 You have to add modifier 95 since they are now telehealth services
 Telephone codes 99441–99443 require audio only but will pay at the rates of 99212–99214
CPT Code Non-facility payment Facility payment
99212 $ 46.13 $ 26.31
99213 $ 76.04 $ 52.26
99214 $ 110.28 $ 80.37
CPT Code 98966-98968
Other qualified health care professionals who may bill Medicare for their services, such as
registered dietitians, social workers, speech-language pathologists, and physical and
occupational therapists should use codes 98966-98968.
CPT Code Non-facility payment
98966 $13.32
98967 $26.64
98968 $39.60

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Code Description
 98966: Telephone evaluation and management service by a qualified non-physician health
care professional to an established patient, parent, or guardian not originating from a
related assessment and management service provided within the previous 7 days nor
leading to an evaluation and management service or procedure within the next 24 hours or
soonest available appointment; 5-10 minutes of medical discussion.
 98967: Telephone call 11-20 minutes
 98968: Telephone call 21-30 minutes
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