In a recent blog, we discussed how CMS has expanded access to telemedicine services for all Medicare patients (see blog here). CMS also recently began allowing Medicare coverage for services provided to patients online, such as communication through a patient portal, or secure messaging. These services are not face-to-face encounters with patients, but rather used to:
Establish if a patient needs a visit
Follow up on an existing problem
Answer patient questions or concerns
Review lab work with the patient
A physician or other qualified healthcare professional discusses, using online communication technologies, a health issue and possible treatment or management with an established patient.
99421 (or 98970 {HCPCS G2061} for non-physician) ~ 5 to 10 minutes
99422 (or 98971 {HCPCS G2061} for non-physician) ~ 11 to 20 minutes
99423 (or 98972 {HCPCS G2061} for non-physician) ~ over 21 minutes
Key Points
Report this code for 5 to 21 minutes of cumulative time spent in communication with the patient over a 7–day period.
The provider communicates with the patient via online communication (for example, a patient portal) to address a health issue for an established patient. During the encounter, the provider responds to the patient's health concerns, answers any medical questions, and recommends management.
The code includes the sum of all communication related to the online encounter, such as phone calls, prescriptions, lab orders, etc.
Document the encounter in the patient's record.