Medicare Telehealth On Hold: What You May Bill

Telehealth is defined as real-time audio-visual services. This is like video conferencing with your patients. Some services can be offered VIRTUALLY, meaning your staff and your patients do not have to meet in real time, either via synchronous audiovisual software or in person. As a public service, I want to remind you of services that you probably ignored when telehealth became so popular.

Here are some codes that most specialties can bill, and Medicare covers.

• Care Management (99490, 99439, 99491, 99437, 99487, 99489, 99424-99427, 99495, 99496)--Many of you are already billing these services with success. But if you have been putting off adding these services, now might be a good time to put your toe in the water and try them.
• RPM/RTM (99453, 99445, 99454, 99470, 99457, 99458, 99091, 98975, 98984, 98976, 98985, 98977, 98986, 98978, 98979, 98980-98981) As we said previously, in 2026, you will not have to do 16 days or more of monitoring to bill these services. Plus, many new devices can support home monitoring. So, what are you waiting for?
• Self-measured blood pressure (99473-99474)--If you have patients with labile hypertension or any condition that makes constant blood pressure monitoring medically necessary, these codes may be used. Check them out if you have patients who could use this.
• E-Visits (99421-99423)--These are communication-based services (CTBS), not telehealth. If you haven't looked at these for a while, online digital E/M services are reported once for the physician's or other QHP's cumulative time devoted to the service over 7 days. The seven-day period begins with the physician's or other QHP's initial, personal review of the patient-generated inquiry. Physician's or other QHP's cumulative service time includes review of the initial inquiry, review of patient records or data pertinent to assessment of the patient's problem, personal physician or other QHP interaction with clinical staff focused on the patient's problem, development of management plans, including physician- or other QHP generation of prescriptions or ordering of tests, and subsequent communication with the patient through online, telephone, email, or other digitally supported communication, which does not otherwise represent a separately reported E/M service. All professional decision-making, assessment, and subsequent management by physicians or other QHPs in the same group practice contribute to the cumulative service time of the patient's online digital E/M service.
• G2010--This is described as: remote evaluation of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, 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. The code is used instead of RPM, so you might find it useful in your practice. For those who cannot bill E/M, there is G2251.
• Brief Check Ins (98016, formerly G2012, G2252, G2250)--You remember this one, don't you? It's a brief communication technology-based service (eg, virtual check-in) by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related evaluation 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.
• Interprofessional Consults (99446-99452)--Sometimes known as "curbside consults, these codes are often unknown to specialists who do the work and do not bill for it. The consultant should use codes 99446, 99447, 99448, 99449, 99451 to report interprofessional telephone/Internet/electronic health record consultations. An interprofessional telephone/Internet/electronic health record consultation is an assessment and management service in which a patient's treating (eg, attending or primary) physician or other qualified health care professional requests the opinion and/or treatment advice of a physician or other qualified health care professional with specific specialty expertise (the consultant) to assist the treating physician or other qualified health care professional in the diagnosis and/or management of the patient's problem without patient face-to-face contact with the consultant. The patient for whom the interprofessional telephone/Internet/electronic health record consultation is requested may be either a new patient to the consultant or an established patient with a new problem or an exacerbation of an existing problem. However, the consultant should not have seen the patient in a face-to-face encounter within the last 14 days. When the telephone/Internet/electronic health record consultation leads to a transfer of care or other face-to-face service (eg, a surgery, a hospital visit, or a scheduled office evaluation of the patient) within the next 14 days or next available appointment date of the consultant, these codes are not reported.

Hopefully, one idea presented here will help you provide remote services that can be paid for while Congress tortures all of us and our patients by failing to accomplish or compromise on an important issue.