Billing for telehealth cancer care
Learn more about policies and reimbursement for telehealth services used in cancer care.
On this page:
Medicare
Medicare policies for telehealth continue to evolve. For the latest information, view the list of telehealth services. The following Current Procedural Terminology (CPT®) and Healthcare Common Procedure Coding System (HCPCS) codes are examples of codes that may apply to telehealth services used in cancer care. The table is not comprehensive, and inclusion does not guarantee coverage or payment. Verify current coverage and coding requirements for the date of service including the service, practitioner, modality, patient location, documentation, and consent.
| CPT/HCPCs code | Description | Time |
|---|---|---|
| 77427 | Radiation treatment management, 5 treatment sessions | N/A |
| 99202 | Office or outpatient visit (new patient) | 15-29 min |
| 99203 | Office or outpatient visit (new patient) | 30-44 min |
| 99204 | Office or outpatient visit (new patient) | 45-59 min |
| 99205 | Office or outpatient visit (new patient) | 60-74 min |
| 99211 | Office or outpatient visit (established patient) | N/A |
| 99212 | Office or outpatient visit (established patient) | 10-19 min |
| 99213 | Office or outpatient visit (established patient) | 20-29 min |
| 99214 | Office or outpatient visit (established patient) | 30-39 min |
| 99215 | Office or outpatient visit (established patient) | 40-54 min |
| G0506 | Comprehensive assessment and care planning during a qualifying chronic care management initiating visit | N/A |
| G2212 | Prolonged office or outpatient evaluation and management service | Additional 15 min |
Tip: Remote patient monitoring and care management services are separate and have their own codes and billing requirements.
Medicaid
Each state has its own billing and reimbursement policies. Review the state Medicaid provider manual, fee schedule, and policy updates for current requirements. Verify current coverage and coding requirements for the date of service, including the service, practitioner, modality, patient location, documentation, and consent. For additional information, visit Medicaid and Medicare overview.
Did you know?
Many states require payers to cover video visits, audio-only visits, remote patient monitoring, asynchronous telehealth, and the patient’s home as an originating site, but the details vary by state.
Private insurance
Check with the patient's insurance company for current telehealth billing and reimbursement policies. Verify current coverage and coding requirements for the date of service including the service, practitioner, modality, patient location, documentation, and consent. For tips on private insurance policies, look up policy by jurisdiction.
Tip: Ask patients to verify their coverage and expected costs before their appointment.
More information:
Billing for telehealth — Health Resources and Services Administration
Medicare and Medicaid policies — Health Resources and Services Administration
Medicare payment policies — Health Resources and Services Administration
Telehealth policy — Health Resources and Services Administration
Understanding telehealth policy — National Telehealth Policy Resource Center