Telehealth has revolutionized the way healthcare is delivered, providing convenient access to
medical services remotely. With the increasing popularity of telehealth, understanding the
associated Current Procedural Terminology (CPT) codes is essential for healthcare providers and
billing professionals. This comprehensive guide aims to demystify telehealth CPT codes, providing
insights into the key codes used for billing and reimbursement in remote care settings.
Telehealth CPT codes are used in billing for virtual healthcare services provided via audio, video,
or other electronic communication methods. These codes enable healthcare providers to accurately
document and bill for telehealth encounters, ensuring proper reimbursement for remote care services.
The following are some common telehealth CPT codes and their descriptions;
Telehealth CPT Codes Cheat Sheet
99441-99443: These codes are used to bill for brief online digital evaluation and management
services.
99441: Telephone E/M service for 5-10 minutes of medical discussion.
99442: Telephone E/M service for 11-20 minutes of medical discussion.
99443: Telephone E/M service for 21-30 minutes of medical discussion.
99421-99423: These codes cover online digital evaluation and management services for established
patients.
99421: Up to 7 days, 5-10 minutes.
99422: 11-20 minutes.
99423: 21 or more minutes.
99201-99215: Evaluation and management (E/M) CPT codes can also be used for telehealth visits,
depending on the complexity and nature of the encounter. These codes cover office or other
outpatient services, including new and established patient visits.
G2010: This code is used for remote evaluation of recorded video and/or images submitted by an
established patient.
G2012: This code covers virtual check-in services, involving brief communication technology-based
assessments by a healthcare provider.
Audio-Only Telehealth CPT Codes
Audio-only telehealth, particularly valuable for patients with limited internet access or technology
resources, requires specific CPT codes for billing and reimbursement. Common CPT codes for
audio-only telehealth include;
98966-98968: These codes are used for telephone assessment and management services, covering various
time increments.
99441-99443: While primarily intended for digital evaluation, these codes may also apply to
telephone-based services for brief medical discussions, covering various time increments.
G2012: This code covers virtual check-in services, including brief communication technology-based
assessments, suitable for audio-only encounters.
Telehealth CPT Codes for Behavioral Health
Behavioral health services delivered via telehealth require specialized CPT codes to accurately
capture the complexity of psychiatric assessments and interventions. Key CPT codes for
telebehavioral health include;
90791-90792: These codes cover psychiatric diagnostic evaluations, including face-to-face assessment
and history gathering.
90832-90838: CPT codes for psychotherapy services, ranging from individual to family therapy
sessions, can be used for telehealth encounters.
96156-96158: These codes are specific to health and behavior assessment and intervention services,
which may be delivered remotely via telehealth platforms.
Inpatient Telehealth CPT Codes
Telehealth is increasingly utilized within inpatient settings to facilitate remote consultations,
follow-up visits, and specialty care delivery. CPT codes applicable to inpatient telehealth services
include:
99451-99452: These codes cover inter professional telephone/internet/electronic health record
consultations provided to inpatients.
99451: Reported by consultant accessing data via EHR, alongside telephone/internet.
99452: Reported by requesting/treating physician/QHP (e.g., primary care physician).
99231-99233: Subsequent hospital care codes may be used for telehealth encounters involving the
management of inpatient services and progress assessment.
99446-99449: CPT codes for care coordination services, including communication with other treating
physicians or facilities, can apply to inpatient telehealth encounters. discussions covering various
time increments
Telehealth CPT Codes for Medicare
Medicare reimbursement policies for telehealth services have evolved, particularly in response to
the COVID-19 pandemic. Understanding Medicare-specific telehealth CPT codes is essential for
compliant billing and reimbursement. Notable telehealth CPT codes for Medicare include;
G0406: Follow-up inpatient consultation, limited, 15 minutes via telehealth
G0407: Follow-up inpatient consultation, intermediate, 25 minutes via telehealth
G0408: Follow-up inpatient consultation, complex, 35 minutes via telehealth
G0425: Telehealth consultation, emergency department or initial inpatient, 30 minutes via telehealth
G0426: Telehealth consultation, emergency department or initial inpatient, 50 minutes via telehealth
G0427: Telehealth consultation, emergency department or initial inpatient, 70 minutes or more via
telehealth
G0508-G0509: Telehealth consultation, critical care, for both new and established patients.
Billing and Reimbursement Considerations: When billing for telehealth services, healthcare providers
must ensure proper documentation of the encounter, including the type of service provided, duration,
and patient consent for telehealth. Additionally, it’s essential to verify payer policies regarding
coverage and reimbursement for telehealth services, as regulations may vary depending on the payer
and state.
Telehealth Expansion During COVID-19: Amid the COVID-19 pandemic, telehealth utilization surged,
prompting temporary expansions in telehealth coverage and reimbursement policies. Many payers
relaxed restrictions on telehealth services, allowing for broader access and reimbursement for
virtual care. However, healthcare providers must stay informed about evolving telehealth regulations
and policy changes to ensure compliance and optimize reimbursement.
Future of Telehealth CPT Codes: As telehealth continues to evolve, so will the landscape of
telehealth CPT codes and billing practices. Healthcare stakeholders must adapt to ongoing changes in
telehealth regulations, technology advancements, and patient preferences to effectively leverage
telehealth for improved access to care and patient outcomes.
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