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CMS issues interim final rule
On Thursday, April 30, 2020, CMS released a new interim final rule. During the COVID-19 Public Health Emergency, the Interim Final Rule makes several new, important temporary changes to Medicare regulations and payments. One important change retroactively (to March 1, 2020) increased payments for telephone-only visits to established patients:
- CPT 99441: a 5- to 10-minute telephone visit, in lieu of a face-to-face office visit, will be reimbursed at a similar rate to a 99212, about $46 (99441 is usually reimbursed at about $14).
- CPT 99442: an 11- to 20-minute telephone visit, in lieu of a face-to-face office visit, will be reimbursed at a similar rate to a 99213, about $76 (99442 is usually reimbursed at about $28).
- CPT 99443: a 21- to 30-minute telephone visit, in lieu of a face-to-face office visit, will be reimbursed at a similar rate to a 99212, about $110 (99443 is usually reimbursed at about $41).
These telephone codes may be used when addressing a new or old problem for established patients. Choose the code to reflect only the billing provider time communicating with the patient. There should not be another patient encounter for 7 calendar days before or after the telephone visit.
In addition, the new Interim Final Rule now allows attending physicians at teaching institutions providing supervision under the Primary Care Exception to report for telephone (using 99441-99443) or video (using 99212-99215) telemedicine encounters by residents, when the supervision is provided immediately after the resident encounter, rather than during the telephone or video visit. However, most chest physicians at teaching institutions do not supervise residents or fellows under the Primary Care Exception.
A CMS press release about the rule is available at cms.gov.
On Thursday, April 30, 2020, CMS released a new interim final rule. During the COVID-19 Public Health Emergency, the Interim Final Rule makes several new, important temporary changes to Medicare regulations and payments. One important change retroactively (to March 1, 2020) increased payments for telephone-only visits to established patients:
- CPT 99441: a 5- to 10-minute telephone visit, in lieu of a face-to-face office visit, will be reimbursed at a similar rate to a 99212, about $46 (99441 is usually reimbursed at about $14).
- CPT 99442: an 11- to 20-minute telephone visit, in lieu of a face-to-face office visit, will be reimbursed at a similar rate to a 99213, about $76 (99442 is usually reimbursed at about $28).
- CPT 99443: a 21- to 30-minute telephone visit, in lieu of a face-to-face office visit, will be reimbursed at a similar rate to a 99212, about $110 (99443 is usually reimbursed at about $41).
These telephone codes may be used when addressing a new or old problem for established patients. Choose the code to reflect only the billing provider time communicating with the patient. There should not be another patient encounter for 7 calendar days before or after the telephone visit.
In addition, the new Interim Final Rule now allows attending physicians at teaching institutions providing supervision under the Primary Care Exception to report for telephone (using 99441-99443) or video (using 99212-99215) telemedicine encounters by residents, when the supervision is provided immediately after the resident encounter, rather than during the telephone or video visit. However, most chest physicians at teaching institutions do not supervise residents or fellows under the Primary Care Exception.
A CMS press release about the rule is available at cms.gov.
On Thursday, April 30, 2020, CMS released a new interim final rule. During the COVID-19 Public Health Emergency, the Interim Final Rule makes several new, important temporary changes to Medicare regulations and payments. One important change retroactively (to March 1, 2020) increased payments for telephone-only visits to established patients:
- CPT 99441: a 5- to 10-minute telephone visit, in lieu of a face-to-face office visit, will be reimbursed at a similar rate to a 99212, about $46 (99441 is usually reimbursed at about $14).
- CPT 99442: an 11- to 20-minute telephone visit, in lieu of a face-to-face office visit, will be reimbursed at a similar rate to a 99213, about $76 (99442 is usually reimbursed at about $28).
- CPT 99443: a 21- to 30-minute telephone visit, in lieu of a face-to-face office visit, will be reimbursed at a similar rate to a 99212, about $110 (99443 is usually reimbursed at about $41).
These telephone codes may be used when addressing a new or old problem for established patients. Choose the code to reflect only the billing provider time communicating with the patient. There should not be another patient encounter for 7 calendar days before or after the telephone visit.
In addition, the new Interim Final Rule now allows attending physicians at teaching institutions providing supervision under the Primary Care Exception to report for telephone (using 99441-99443) or video (using 99212-99215) telemedicine encounters by residents, when the supervision is provided immediately after the resident encounter, rather than during the telephone or video visit. However, most chest physicians at teaching institutions do not supervise residents or fellows under the Primary Care Exception.
A CMS press release about the rule is available at cms.gov.