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Telehealth for American Indian and Alaska Native communities

Billing for telehealth in American Indian and Alaska Native communities

Funding for Indian Health Service (IHS) programs is primarily provided through specific congressional appropriations. It is also supplemented by reimbursements from Medicare, Medicaid, and private insurance payers.

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 American Indian and Alaska Native communities and include updates provided to the 2022 Medicare Physician Fee Schedule – PFS.

Coding guidance is subject to change. Please refer to the complete list of telehealth services covered by Medicare during the COVID-19 public health emergency from the Centers for Medicare & Medicaid Services.

Behavioral Health

Audio-only or video telehealth

Although Medicare reimburses for audio and video telehealth, audio-only reimbursement is currently covered only during the COVID-19 public health emergency.

Category Telehealth CPT codes and HCPCS codes

Aphasia and cognitive assessment

96105, 96125

Behavioral screening

96127

Diagnostic evaluation

90791, 90792

Psychotherapy

90832, 90833, 90834, 90836, 90837, 90838

Psychoanalysis

90845

Group psychotherapy

90853

Family psychotherapy

90846, 90847

Psychological and neurobehavioral testing or status exam

96116, 96121, 96130, 96131, 96132, 96133, 96136, 96137, 96138, 96139

Crisis intervention and interactive complexity

90839, 90840, 90785

Speech-language behavioral analysis

92524

Psychological evaluation

96130, 96131

Neuropsychological evaluation

96132, 96133

Psychological & neuropsychological test administration & scoring

96136, 96137, 96138, 96139

Health behavior assessment

96156, 96160, 96161

Health behavior intervention, individual

96158, 96159

Health behavior intervention, group

96164, 96165

Health behavior intervention, family with patient

96167, 96168

Developmental screening and testing

96112, 96113

Adaptive behavior assessment

97151, 97152, 0362T

Adaptive behavior treatment

97153, 97154, 97155, 97156, 97157, 97158, 0373T

Therapeutic interventions

97129, 97130

Therapeutic interventions (group)

97150

Smoking and tobacco use counseling

99406, 99407

Screening, brief intervention, and referral to treatment

G0396, G0397 G0442, G0443, G0444, G0445, G0446, G0447

Opioid use disorder treatment

G2086, G2087, G2088

Non-covered services

It is important to note that these behavioral health services are not Medicare reimbursable.

Category Telehealth CPT codes

Developmental screening and testing

96110

Health behavior intervention, family without patient

96170, 96171

Psychophysiological therapy

90875

Diabetes Management

Category Telehealth CPT codes and HCPCS codes

Evaluation and monitoring outpatient follow-up

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

Diabetes management

G0108

Medical nutrition therapy

97802, 97803

Uninsured or underinsured patients

According to 2019 Census data, the American Indian and Alaska Native population has the highest uninsured rate compared to other populations.

Providers can help provide high-quality care to these communities by offering free or low cost services, including:

  • Free or low cost annual wellness visits
  • Free or low cost well child visits

More resources