Stephanie Allard, DoctorsManagement, LLC

Many practices and providers have looked to bill additional services during the pandemic, but they do not always understand how to do that compliantly. The Medicare listing for telehealth services lists CPT code 99211 as a covered code for telehealth services. This would be the only service that can be billed by an RN for an interactive telehealth encounter, as the CPT code is usually reserved for use by RNs. Per CMS the encounter does have to be interactive with both audio and video used to bill 99211. The patient must request and consent to the encounter, meaning the visit would be in place of one that would typically take place in the office. 

If the patient requested and consented and the encounter is audio a Telephone E/M code 98966 – 98968 must be coded instead based on the total time spent in medical discussion with the patient and documented in the note. 

I have seen practices this year that are wanting to bill telehealth for a scenario when a provider or nurse is calling a patient back with test results or for quick updates that would not typically result in an office visit. These types of calls would still remain as not separately billable services. 

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