based on summary article by Orly Avitzur, Neurology Today based ona presentation by health care lawyer Daniel Brown.
New CPT codes for telephone/internet assessment when provided doctor to doctor by a consultant-- codes 99446-99449. May be used for complex and urgent situations when face to face is not practical. These are time based only codes and only available to consulting specialist. MEDICARE DOES NOT PAY FOR THESE CODES, "check with commercial payors about their policies"
EMAIL (CPT code 98969 and 99444) and phone calls from patients (98966-98968 or 99441-99443) for after hours requests for routine refills of Rx and other requests. Medicare does not cover these, because they are considered to be included in face to face. With proper documentation, though you can add time of phone call to the time of the next visit IF its associated with the patient's next visit. You can factor phone call into the time/complexity calculation of next visit. Remember that using time , fifty percent of time must be face to face. If a patient calls several moths after an appointment for an unrelated question, that could be considered a separate service.
Can doctor bill the patient directly for internet consults? Answer is yes, but CMS "strongly encourages " and advanced beneficiary notice (ABN) before billing so patients can make an informed decision. Also, MD must not duplicate a service performed at a subsequent visit, the components follow the descriptions in CPT code, and the services are adequately documented.
Bill for forms? OK to bill for copying, filling forms for camp, or work UNLESS its part of that outpatient visit.
Prior authorizations? MEDICARE STRONGLY BELIEVES THAT IS AN UNREIMBURSED COST INCURRED BY THE PHYSICIAN
New CPT codes for telephone/internet assessment when provided doctor to doctor by a consultant-- codes 99446-99449. May be used for complex and urgent situations when face to face is not practical. These are time based only codes and only available to consulting specialist. MEDICARE DOES NOT PAY FOR THESE CODES, "check with commercial payors about their policies"
EMAIL (CPT code 98969 and 99444) and phone calls from patients (98966-98968 or 99441-99443) for after hours requests for routine refills of Rx and other requests. Medicare does not cover these, because they are considered to be included in face to face. With proper documentation, though you can add time of phone call to the time of the next visit IF its associated with the patient's next visit. You can factor phone call into the time/complexity calculation of next visit. Remember that using time , fifty percent of time must be face to face. If a patient calls several moths after an appointment for an unrelated question, that could be considered a separate service.
Can doctor bill the patient directly for internet consults? Answer is yes, but CMS "strongly encourages " and advanced beneficiary notice (ABN) before billing so patients can make an informed decision. Also, MD must not duplicate a service performed at a subsequent visit, the components follow the descriptions in CPT code, and the services are adequately documented.
Bill for forms? OK to bill for copying, filling forms for camp, or work UNLESS its part of that outpatient visit.
Prior authorizations? MEDICARE STRONGLY BELIEVES THAT IS AN UNREIMBURSED COST INCURRED BY THE PHYSICIAN
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