Medicare Increases Reimbursement for Telephone Visits

Medicare’s previous order to expand its list of approved telehealth services failed to address one key issue: reimbursement for telephone only services. The previous order focused instead on video conferencing encounters, seemingly ignoring the fact that many Medicare patients do not have access to, or are not comfortable with such technology. This oversight burdened physicians nationwide who were forced to rely on telephone visits to treat many of their patients and received significantly lower reimbursement.

Under pressure from the medical community to fix this flaw, CMS recently announced they would increase the allowed rates for telephone visits to match traditional office visits. These services include CPT codes 99441 – 99443 (descriptions below). Retroactive to March 1, 2020, Medicare will now pay the three codes using the same allowable rates as 99212, 99213, and 99214.

99441: Telephone E&M service for an established patient, not originating from a related E&M service provided in the last 7 days, or a service to be provided in the next 24 hours; 5-10 minutes of discussion

99442: Telephone E&M service for an established patient, not originating from a related E&M service provided in the last 7 days, or a service to be provided in the next 24 hours; 11-20 minutes of discussion

99443: Telephone E&M service for an established patient, not originating from a related E&M service provided in the last 7 days, or a service to be provided in the next 24 hours; 21-30 minutes of discussion

See the full announcement from CMS at the link below:

https://www.cms.gov/files/document/covid-19-physicians-and-practitioners.pdf