Billing

What Are the CPT Codes for Telehealth?

Master billing with Healthie's guide to CPT codes for telehealth services. Understand CMS guidelines and access the right codes for seamless reimbursement.

Telehealth has transformed the healthcare industry, providing innovative solutions to some of its most persistent challenges. Telehealth not only enhances patient access to care but also offers healthcare professionals an efficient way to deliver services. To ensure proper reimbursement and accurate billing for telehealth services, it's crucial to understand the relevant Current Procedural Terminology (CPT) codes. In this blog post, we'll delve into the world of telehealth CPT codes, explaining their significance, usage, documentation requirements, and how they differ from in-person service codes.

What Are Telehealth CPT Codes?

CPT codes for telehealth services are alphanumeric codes used to describe specific medical procedures and services provided during remote healthcare consultations. These codes help healthcare providers and insurers communicate precisely which services were rendered, facilitating proper reimbursement.

Here are some common CPT codes for telehealth services:

CPT Code 99441-99443: Audio-Only Telehealth Services

These CPT codes for audio only telehealth are used when healthcare professionals provide medical services to patients via telephone. They are particularly useful for patients who may not have access to video-enabled devices or reliable internet connections.

CPT Code 99201-99215: Evaluation and Management Services

These codes cover various levels of evaluation and management services conducted through telehealth, including consultations, follow-up visits, and mental health assessments.

CPT Code 90791-90792: Psychiatric Diagnostic Evaluation

These codes are used for initial psychiatric evaluations and can be applied to telehealth visits when a psychiatrist assesses a patient remotely.

What Is the ICD-10 Code for Telehealth Visit?

In addition to CPT codes, telehealth visits may require the use of International Classification of Diseases, Tenth Revision (ICD-10) codes. These codes describe the patient's diagnosis or condition and are essential for proper billing and documentation. The specific ICD-10 code you use will depend on the patient's symptoms, condition, or reason for the telehealth visit. It's important to choose the most accurate and specific code to support proper reimbursement.

How Do Telehealth CPT Codes Differ From In-Person Service Codes?

While CPT codes for telehealth and in-person services may describe the same procedures, they can differ in certain ways. For instance, telehealth codes often include modifiers, such as "95" or "GT," to indicate that the service was provided remotely. Understanding these differences is crucial for accurate billing. Additionally, the Centers for Medicare & Medicaid Services (CMS) periodically update their guidelines for telehealth services, so it's essential to stay informed about the latest changes to ensure compliance.

How Do I Document Telehealth Services to Support Proper Coding and Billing?

Accurate documentation is key to proper coding and billing for telehealth services. Healthcare providers should maintain thorough records of each telehealth encounter, including the patient's medical history, assessment, treatment plan, and any prescriptions issued. This documentation not only supports coding and billing but also ensures the delivery of high-quality care and effective communication with other healthcare providers involved in the patient's treatment.

Understanding CPT codes for telehealth is essential for healthcare professionals looking to offer remote medical services. 

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