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A health care provider offering a virtual handshake to a patient with a chronic condition.

Telehealth for chronic conditions

Billing for telehealth services to treat chronic conditions

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
G0506 Comprehensive 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
96164Health behavior intervention, group 30 minYesYes
96165Health behavior intervention, group Additional 15 minYesYes
96167Health behavior intervention, patient with family30 minYesYes
96168Health behavior intervention, patient with familyAdditional 15 minYesYes
96170Health behavior intervention, family without patient30 minNoNo
96171Health behavior intervention, family without patientAdditional 15 minNoNo
97802Medical nutrition therapy, initial assessment15 minYesYes
97803Medical nutrition, re-assessment15 minYesYes
97804Medical nutrition, group assessment30 minYesYes
99453Remote patient monitoring (RPM) devices set upN/AN/ANo
99454Monitoring data from RPM deviceN/AN/ANo
99457Patient-provider communication related to RPM data20 minYesNo
99458Patient-provider communication related to RPM dataAdditional 20 minYesNo
G0270Medical nutrition therapy, reassessment, intervention15 minYesYes
G0447Obesity counseling15 minYesYes

Cardiovascular conditions

CPT/HCPCs codeDescriptionTimeAudio-only coveragePermanent coverage for telehealth
93750Interrogation of ventricular assist deviceN/ANoNo
93797Cardiac rehabilitation, without ECG60 minNoNo
93798Cardiac rehabilitation, with ECG60 minNoNo
99473Self-measured blood pressure, education and trainingN/ANoNo
G0422Intensive cardiac rehabilitation with exercise60 minNoNo
G0423Intensive cardiac rehabilitation without exercise60 minNoNo
G0446Intensive behavioral therapy for cardiovascular disease15 minYesYes

Pulmonary disease

CPT/HCPCs codeDescriptionTimeAudio-only coveragePermanent coverage for telehealth
94005Home ventilator management supervisionN/ANoNo
94625Pulmonary rehabilitation, without monitoring60 minNoNo
94626Pulmonary rehabilitation with monitoring60 minNoNo
94664Demonstration or evaluation of use of inhalerN/ANoNo

Diabetes

CPT/HCPCs codeDescriptionTimeAudio-only coveragePermanent coverage for telehealth
G0108Diabetes self-management training, individual30 minYesYes
G0109Diabetes self-management training, group30 minYesYes

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