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Revised Guidelines for CPT 99441 - 99443

CMS will pay for phone calls using codes 99441—99443. The 4/30/20 rule adds these to the telehealth list and increased payment for these services

These codes previously had a non-covered status and the Physicians, nurse practitioners, and physician assistants should use codes 99441—99443
  • 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 - 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; 11-20 minutes of medical discussion
  • 99443 - 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; 21-30 minutes of medical discussion
CMS continues did not add 98966–98968 to the telehealth list,

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
  • 98966 - Telephone assessment and management service provided 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 assessment and management service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion
  • 98967 - Telephone assessment and management service provided 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 assessment and management service or procedure within the next 24 hours or soonest available appointment; 11-20 minutes of medical discussion
  • 98968 - Telephone assessment and management service provided by a qualified nonphysician 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 assessment and management service or procedure within the next 24 hours or soonest available appointment; 21-30 minutes of medical discussion
New! 99441–99443 have been added to the telehealth list, so use the place of service that would have been furnished. In most cases, this will be place of service office (11) or outpatient department (19, 22). Since they are now telehealth services, add modifier 95

CMS has changed the rates for codes 99441–99443 to the rates for 99212–99214.

***Telephone codes 99441–99443 require audio only but will pay at the rates of 99212–99214 

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