Telehealth has revolutionized the healthcare industry, enabling medical professionals to provide care to patients virtually, overcoming geographical barriers and creating new possibilities for patient care. As this landscape changes, medical billing procedures also need to adapt. Let's explore the impact of telehealth on medical billing and how to navigate these changes effectively.
Expansion of Telehealth Service
The pandemic accelerated the adoption of telehealth, and as a result, the preference for virtual care is here to stay. According to the American Medical Association, 75 to 80 percent of all physician, urgent care, and ER visits could be done effectively and safely over the phone or video. However, billing for these services isn't as straightforward as in-person visits. Insurance reimbursement for telehealth services has been a significant area of change. Initially, many insurance providers did not cover virtual visits or had highly restrictive policies. However, in light of the pandemic, many insurers have expanded their coverage for telehealth services, but the policies can vary widely between insurance providers.
Understanding Telehealth Billing Codes
Telehealth services use different billing codes compared to traditional in-person visits. These include different Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) codes. In the early days of telehealth, this led to confusion and mistakes. However, as telehealth becomes more integrated into standard practice, understanding and correctly applying these codes is crucial.
· CPT 99201-99215: These are the standard CPT codes for office visits and can be used for telehealth visits, provided the service is similar to an in-person visit, is conducted via an interactive audio and video telecommunications system, and the provider documents the medical necessity for the visit.
· HCPCS G2010: This code is used to bill for remote evaluation of recorded video or images submitted by an established patient (e.g., for a rash or wound).
· HCPCS G2012: This code is used to bill for a brief (5-10 minutes) "virtual check-in" with a patient via telephone or other telecommunications device to decide whether an office visit or other service is needed.
· HCPCS G2061-G2063: These are codes used for patient-initiated digital communications that require a clinical decision from the provider (usually a non-physician healthcare professional).
· CPT 99441-99443: Telephone evaluation and management service by a physician or other qualified healthcare professional who may report evaluation and management services provided to an established patient, parent, or guardian 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 hours or soonest available appointment.
The Future of Telehealth and Medical Billing
With the rising demand for telehealth services, it's important to adapt your medical billing process to keep pace with these changes. With the right strategies, you can successfully navigate the intricacies of telehealth billing, ensuring you get reimbursed correctly and promptly for the valuable services you offer.
At Reticle, we specialize in navigating the evolving landscape of medical billing, including telehealth services. Our team stays abreast of the latest changes in billing codes, insurance policies, and regulations, ensuring your practice maintains compliance and maximizes revenue. Let us handle the complexities of telehealth billing, so you can focus on providing excellent patient care.
Don't let the challenges of telehealth medical billing hold back your practice. Reach out to us today to schedule a conversation with our team. We’re experts in managing the billing processes specific to telehealth services for small and mid-sized medical practices. Together, we can build a robust and effective medical billing system for your practice. Your peace of mind is our priority. Contact us today.