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