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A health care provider speaks with a patient with H-I-V through telehealth.

Telehealth for HIV care

Billing for HIV care via telehealth

Learn about policies and reimbursement for telehealth services.

Medicare

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.

Primary care

CPT/HCPCs codeDescriptionTimeAudio-only coveragePermanent coverage for telehealth
98960Self-management, individual patient30 minNoNo
98961Self-management training, group (2-4 individuals)30 minNoNo
98962Self-management training, group (5-8 individuals)30 minNoNo
98966Telephone call for assessment and management by non-physician5-10 minYesYes
98967Telephone call for assessment and management by non-physician11-20 minYesYes
98968Telephone call for assessment and management by non-physician21-30 minYesYes
99202Outpatient visit (new patient)15-29 minNoYes
99203Outpatient visit (new patient)30-44 minNoYes
99204Outpatient visit (new patient)45-59 minNoYes
99205Outpatient visit (new patient)60-74 minNoYes
99211Outpatient visit (established patient)5 minNoYes
99212Outpatient visit (established patient)10-19 minNoYes
99213Outpatient visit (established patient)20-29 minNoYes
99214Outpatient visit (established patient)30-39 minNoYes
99215Outpatient visit (established patient)40-55 minNoYes
99441Telephone call for evaluation and management5-10 minYesNo
99442Telephone call for evaluation and management11-20 minYesNo
99443Telephone call for evaluation and management21-30 minYesNo
G0438Initial annual wellness visitN/AYesYes
G0439Subsequent annual wellness visitN/AYesYes
G0506Comprehensive assessment care planN/AYesYes
G2212Prolonged outpatient visitAdditional 15 minYesYes

Disease management

CPT/HCPCs codeDescriptionTimeAudio-only coveragePermanent coverage for telehealth
96156Health behavior assessmentN/AYesYes
96158Health behavior intervention30 minYesYes
96159Health behavior interventionAdditional 15 minYesYes
96160Patient-focused health risk assessment using standardized instrumentN/AYesYes

Medicaid

Each state has its own billing and reimbursement policies. For tips on Medicaid policies, visit Medicaid and Medicare overview.

Private insurance

Find out if the patient has private insurance. If so, 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 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

Understanding telehealth policy — National Telehealth Policy Resource Center