Billing for direct-to-consumer telehealth
Learn about policies and reimbursement for DTC telehealth services.
On this page:
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.
| CPT/HCPCS code | Description | Time | Audio-only coverage | Permanent coverage for telehealth |
|---|---|---|---|---|
| 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 |
| 99202 | Outpatient visit (new patient) | 15-29 min | No | Yes |
| 99203 | Outpatient visit (new patient) | 30-44 min | No | Yes |
| 99204 | Outpatient visit (new patient) | 45-59 min | No | Yes |
| 99205 | Outpatient visit (new patient) | 60-74 min | No | Yes |
| 99441 | Telephone call for evaluation and management | 5-10 min | Yes | No |
| 99442 | Telephone call for evaluation and management | 11-20 min | Yes | No |
| 99443 | Telephone call for evaluation and management | 21-30 min | Yes | No |
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
Telehealth policy — Health Resources and Services Administration
Medicare and Medicaid policies — Health Resources and Services Administration
Medicare payment policies — Health Resources and Services Administration
Understanding telehealth policy — National Telehealth Policy Resource Center