Billing for telehealth for diabetes care
Learn more about policies and reimbursement for telehealth services.
On this page:
Medicare billing guidance
The Centers for Medicare and Medicaid Services (CMS) has expanded Medicare coverage for telehealth. Many state Medicaid programs and private insurers also cover telehealth appointments.
Coding guidance is subject to change. Below is a list of the telehealth services that are reimbursed under Medicare including services that can be provided using audio only technology. Some of these services are permanently covered under Medicare while other telehealth services are only eligible for reimbursement by Medicare through December 2024. Please refer to the complete list of telehealth services reimbursed by Medicare from the Centers for Medicare & Medicaid Services.
| CPT/HCPCs code | Description | Time | Audio-only coverage | Permanent coverage for telehealth |
|---|---|---|---|---|
| 96158 | Health behavior intervention | 30 min | Yes | Yes |
| 96159 | Health behavior intervention | Additional 30 min | Yes | Yes |
| 97802 | Medical nutrition, initial assessment | 15 min | Yes | Yes |
| 97803 | Medical nutrition, reassessment | 15 min | Yes | Yes |
| 97804 | Medical nutrition, group assessment | 30 min | Yes | No |
| 98960 | Self-management training, individual patient | 30 min | No | No |
| 98961 | Self-management training, group (2-4 individuals) | 30 min | No | No |
| 98962 | Self-management training, group (5-8 individuals) | 30 min | No | No |
| 98966 | Telephone call for assessment and management by non-physician | 5-10 min | Yes | Yes |
| 98967 | Telephone call for assessment and management by non-physician | 11-20 min | Yes | Yes |
| 98968 | Telephone call for assessment and management by non-physician | 21-30 min | Yes | Yes |
| 99091 | Remote patient monitoring (RPM) data review and patient education | 30 min | Yes | No |
| 99441 | Telephone call for E&M | 5-10 min | Yes | No |
| 99442 | Telephone call for E&M | 11-20 min | Yes | No |
| 99443 | Telephone call for E&M | 21-30 | Yes | No |
| 99453 | Device set up and patient training | N/A | N/A | No |
| 99454 | Monitoring of RPM data | N/A | N/A | No |
| 99457 | Patient-provider communication related to RPM data | 20 min | Yes | No |
| 99458 | Patient-provider communication related to RPM data | Additional 20 min | Yes | No |
| G0108 | Diabetes self-management training, individual | 30 min | Yes | Yes |
| G0109 | Diabetes self-management training, group | 30 min | Yes | Yes |
| G0270 | Medical nutrition therapy, reassessment, intervention | 15 min | Yes | Yes |
| G0447 | Obesity counseling | 15 min | Yes | Yes |
| G0506 | Comprehensive assessment care plan | N/A | Yes | Yes |
| G0513 | Prolonged prevention services | 30 min | Yes | Yes |
| G0514 | Prolonged prevention services | Additional 30 min | Yes | Yes |
| G3002 | Chronic pain treatment | 30 min | No | Yes |
| G3003 | Chronic pain treatment | Additional 15 min | No | 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 providers- what should I know? (PDF) — 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