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Telehealth and cancer care

Billing for cancer care via telehealth

Many billing codes and payment policies for cancer diagnosis and management are the same whether used for telehealth or in-person services, while some are specific to telehealth.

As you prepare to launch your telehealth cancer care program or improve your existing practice, take time to fully understand your billing options. You may need to consider additional training so your office is ready to seamlessly handle telehealth billing.

Get more information on billing for direct-to-consumer telehealth.

Medicare billing guidance

The following common Current Procedural Terminology (CPT®) and Healthcare Common Procedure Coding System (HCPCS) codes are used to bill for services for telemedicine in cancer care or diagnosis.

Coding guidance is subject to change. Please refer to the complete list of telehealth services covered by Medicare from the Centers for Medicare & Medicaid Services.

Audio-only or video telehealth

Category Teleheath CPT codes and HCPCS codes

Cancer care: Phone evaluation and management

99441, 99442, 99443

Cancer care: Radiation oncology treatment management

77427

Telephone evaluation and management service

99441, 99442, 99443, G0438, G0439

Screening, brief intervention, and referral to treatment

G0444, G0445, G0459

Evaluation and monitoring outpatient follow-up

99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215

Initial hospital care

99221, 99222, 99223

Health behavior assessment

96156, 96160, 96161

Health behavior intervention

96158, 96159

More resources

Medicare Coverage and Payment of Virtual Services (video) — from the Centers for Medicare & Medicaid Services

Medicare telemedicine health care provider fact sheet — Centers for Medicare & Medicaid Services (CMS)

Current State Laws & Reimbursement Policies — from the National Policy Center - Center for Connected Health Policy