Billing for telehealth in emergency departments
During the COVID-19 public health emergency, additional emergency care services are covered by Medicare as telehealth. Other related services, such as remote patient monitoring and e-consults, are not considered telehealth for billing purposes, but are reimbursable.
On this page:
Medicare billing guidance
Below are common codes used to bill for these services. Note: some of these services are temporarily covered during the COVID-19 public health emergency.
| Category | Billing and telehealth CPT codes |
|---|---|
|
Emergency department |
Evaluation and management: 99281, 99282, 99283, 99284, 99285 |
|
Critical care |
First hour: 99291 Additional 30 min: 99292 |
|
Observation services |
Discharge: 99217 Initial: 99218, 99219, 99220 Subsequent: 99224, 99225, 99226 Observation / discharge on same day: 99234, 99235, 99236 |
|
Hospital discharge day management |
Less than 30 minutes: 99238 30 minutes or more: 99239 |
|
E-consults (interprofessional consults) |
Verbal and written report: 99446, 99447, 99448, 99449 Written report only: 99451 |
|
Remote patient monitoring |
99453, 99454 — 16 day minimum monitoring requirement is waived during the COVID-19 public health emergency (2 days minimum) 99457, 99458, 99091 |
Tip: Services provided virtually while the provider and patient are in the same location — for instance, over a tablet from different rooms within a hospital — are not billed as telehealth.
For more details about billing and reimbursement:
- See the complete list of telehealth services covered by Medicare during the public health emergency from the Centers for Medicare & Medicaid Services
Medicaid
While each state is different, most have expanded coverage for telehealth due to COVID-19. Many are now matching Medicare’s telehealth coverage. Check your state’s current laws and reimbursement policies to see what is covered. For updates on COVID-19 reimbursement and related Medicaid codes and procedures for your state, see:
- COVID-19 Related State Actions — from the National Policy Center - Center for Connected Health Policy
- Coverage and Payment of Interprofessional Consultation (PDF) — Centers for Medicare and Medicaid Services
Private insurance
Many code changes for COVID-19 care cover telehealth and include specific information for visits that are video- or audio-only. It is important to note that most states distinguish between reimbursement standards for permanent telehealth policies and temporary COVID-19 reimbursement policies. For tips on coding private insurance claims, see:
- Current State Laws & Reimbursement Policies (Private Payer Laws) — from the National Policy Center - Center for Connected Health Policy
- Coding Scenarios during COVID-19 — from the American Academy of Family Physicians
Have a question?
Contact the staff at the regional telehealth resource center that’s closest to you for help with your telehealth program.