Billing for telehealth for diabetes care
Learn more about policies and reimbursement for telehealth services.
On this page:
Medicare billing guidance
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 frequently used to bill for telehealth services. Coding guidance is subject to change.
| CPT/HCPCs code | Description | Time | Permanent coverage for telehealth |
|---|---|---|---|
| 96158 | Health behavior intervention | 30 min | Yes |
| 96159 | Health behavior intervention | Additional 30 min | Yes |
| 97802 | Medical nutrition, initial assessment | 15 min | Yes |
| 97803 | Medical nutrition, reassessment | 15 min | Yes |
| 97804 | Medical nutrition, group assessment | 30 min | No |
| 98960 | Self-management training, individual patient | 30 min | No |
| 98961 | Self-management training, group (2-4 individuals) | 30 min | No |
| 98962 | Self-management training, group (5-8 individuals) | 30 min | No |
| 98966 | Telephone call for assessment and management by non-physician | 5-10 min | Yes |
| 98967 | Telephone call for assessment and management by non-physician | 11-20 min | Yes |
| 98968 | Telephone call for assessment and management by non-physician | 21-30 min | Yes |
| 99091 | Remote patient monitoring (RPM) data review and patient education | 30 min | No |
| 99453 | Device set up and patient training | N/A | No |
| 99454 | Monitoring of RPM data | N/A | No |
| 99457 | Patient-provider communication related to RPM data | 20 min | No |
| 99458 | Patient-provider communication related to RPM data | Additional 20 min | No |
| G0108 | Diabetes self-management training, individual | 30 min | Yes |
| G0109 | Diabetes self-management training, group | 30 min | Yes |
| G0270 | Medical nutrition therapy, reassessment, intervention | 15 min | Yes |
| G0447 | Obesity counseling | 15 min | Yes |
| G0506 | Comprehensive assessment care plan | N/A | Yes |
| G0513 | Prolonged prevention services | 30 min | Yes |
| G0514 | Prolonged prevention services | Additional 30 min | Yes |
| G3002 | Chronic pain treatment | 30 min | Yes |
| G3003 | Chronic pain treatment | Additional 15 min | Yes |
Medicaid
Each state has its own billing and reimbursement policies. For tips on Medicaid policies, visit Medicaid and Medicare overview.
Private insurance
Check with the patient's insurance company for information on their billing and reimbursement policies. For tips on private insurance policies, look up policy by jurisdiction.
More information:
Billing and payment policies for telehealth services to treat chronic conditions — Health Resources and Services Administration
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
Medicare Coverage of Diabetes Supplies — Centers for Medicare & Medicaid Services
Understanding telehealth policy — National Telehealth Policy Resource Center