covid-19-web-banner

News & Publications

Guide to Telehealth: Billing for Telephone Calls


During the COVID-19 public health emergency, Medicare as well as many private payers have approved coverage of telephone only (no video) services billed using an existing set of three CPT codes (99441-99443). CMS has also agreed to reimburse for phone calls made to both new and established patients.

On April 30, CMS released a new regulation which updated the reimbursement rates for telephone calls. Telephone call services will now be reimbursed at a rate comparable to office and outpatient E/M services for the duration of the public health emergency. These new rates are retroactively effective March 1, 2020. In addition to updated rates, CMS has also recently indicated that it will require providers to use modifier -95 when billing for telephone calls.


Code

Descriptor

Non-Facility Fee

Facility Fee

99441

Telephone E/M service provided by a physician to an established patient, 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 hrs or soonest available appointment, 5-10 medical discussion

$46.13

$26.31

99442

Telephone E/M service provided by a physician to an established patient, 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 hrs or soonest available appointment, 11-20 minutes

$76.04

$52.26

99443

Telephone E/M service provided by a physician to an established patient, 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 hrs or soonest available appointment, 21-30 minutes

$110.28

$80.37