Billing and coding Medicare Fee-for-Service claims
More Medicare Fee-for-Service (FFS) services are billable as telehealth during the COVID-19 public health emergency. Read the latest guidance on billing and coding FFS telehealth claims.
Billing codes covered by Medicare
Medicare added over one hundred CPT and HCPCS codes to the telehealth services list for the duration of the COVID-19 public health emergency.
Telehealth visits billed to Medicare are paid at the same Medicare Fee-for-Service (FFS) rate as an in-person visit during the COVID-19 public health emergency.
Coverage after COVID-19 ends
Some telehealth codes are only covered until the Public Health Emergency Declaration ends.
Medicare is covering a portion of codes permanently under the 2021 Physician Fee Schedule. In addition, many codes are covered temporarily through at least the end of 2021.
This National Telehealth Policy Resource Center fact sheet (PDF) summarizes temporary and permanent changes to telehealth billing.
Coding claims during COVID-19
Telephone visits and audio-only telehealth
Medicare increased payments for certain evaluation and management visits provided by phone for the duration of the COVID-19 public health emergency:
- CPT codes 99441 (5-10 minutes), 99442 (11-20 minutes), and 99443 (20-30 minutes)
- Reimbursements match similar in-person services, increasing from about $14-$41 to about $60-$137, retroactive to March 1, 2020
In addition, Medicare is temporarily waiving the audio-video requirement for many telehealth services during the COVID-19 public health emergency.
Codes that have audio-only waivers during the public health emergency are noted in the list of telehealth services. Medicare is establishing new billing guidelines and payment rates to use after the emergency ends.
Place of Service codes and modifiers
When billing telehealth claims for services delivered on or after March 1, 2020, and for the duration of the COVID-19 emergency declaration:
- Include Place of Service (POS) equal to what it would have been had the service been furnished in person.
- Append modifier 95 to indicate the service took place via telehealth.
The CR modifier is not required when billing for telehealth services.
Hospital billing for remote visits
Hospitals can bill HCPCS code Q3014, the originating site facility fee, when a hospital provides services via telehealth to a registered outpatient of the hospital.
Under the emergency waiver in effect, the patient can be located in any provider-based department, including the hospital, or the patient’s home.
For more details, see:
- COVID-19 Frequently Asked Questions (FAQs) on Medicare Fee-for-Service (FFS) Billing (PDF, see “Hospital Billing for Remote Services” section) — from the Centers for Medicare & Medicaid Services
COVID-19 testing and counseling
For details about how to bill Medicare for COVID-19 counseling and testing, see:
- Medicare Fee-For-Service (FFS) Response to the Public Health Emergency on the Coronavirus (COVID-19) — from the Centers for Medicare & Medicaid Services
More information about FFS billing
If you are looking for detailed guidance on what is covered and how to bill Medicare FFS claims, see:
- COVID-19 Frequently Asked Questions (FAQs) on Medicare Fee-for-Service (FFS) Billing (PDF) — from the Centers for Medicare & Medicaid Services