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Best practice guide

Telehealth for chronic conditions
For providers Best practice guides Telehealth for chronic conditions

Billing and payment policies for telehealth services to treat chronic conditions

Many billing codes and payment policies for chronic condition treatment and management are the same whether used for telehealth or in-person services. There are, however, some codes specific to telehealth.

As you prepare to launch your telehealth care program, take time to fully understand your billing options. You may need to consider extra staffing or additional training so your office is ready to seamlessly handle telehealth billing.

Many private insurers are also covering telehealth appointments, with patients paying their typical co-pay. You can also choose to offer a discounted cash pay program or private payment options for the underinsured or the uninsured.

One possible way to offer discounted payment is to find stakeholders willing to partner with you. You could also explore local, state, and federal grant funding options.

Quick resources

Get more information on billing for direct-to-consumer telehealth.
Read more about billing and reimbursement for telehealth during the COVID-19 public health emergency.

Medicare billing guidance

The following common Current Procedural Terminology (CPT®) and Healthcare Common Procedure Coding System (HCPCS) codes are used to bill for services for telemedicine for chronic conditions, and include updates provided to the 2022 Medicare Physician Fee Schedule – PFS (PDF).

Coding guidance is subject to change. Please refer to the complete list of telehealth services covered by Medicare during the COVID-19 public health emergency from the Centers for Medicare & Medicaid Services.

Audio-only or video telehealth

Billing codes
Category Telehealth CPT codes and HCPCS codes

Telephone evaluation and management service

99441, 99442, 99443, G0438, G0439

Screening, brief intervention, and referral to treatment

G0396, G0397, G0442, G0443, G0444, G0445, G0446, G0447

Evaluation and monitoring outpatient follow-up

99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215

Observation care discharge

99217*

Initial observation care

99218, 99219, 99220**

Subsequent observational care

99224, 99225, 99226

Opioid use disorder treatment

G2086, G2087, G2088

Alcohol and substance abuse assessment

G0396, G0397

Diabetes Care Management: Phone evaluation and management

99441, 99442, 99443

Diabetes self-management training

G0108, G0109

Medical nutrition therapy

97802, 97803, 97804, G0270

Psychotherapy

90785, 90791, 90792, 90832, 90833, 90834, 90836, 90837, 90838

Renal Care: Phone evaluation and management

99441, 99442, 99443

Renal Care: Outpatient dialysis services

90951, 90952, 90953, 90954, 90955, 90956, 90957 ,90958, 90959, 90960, 90961, 90962

Renal Care: Hospital care services, with the limitation of 1 telehealth visit every 3 days

99231, 99232, 99233

Renal Care: Individual and group kidney disease education

G0420, G0421

Renal Care: Transitional care management services

99495, 99496

Renal Care: Advance care planning

99497, 99498

Renal Care: Prolonged service

99354, 99355, 99356, 99357

Renal Care: Telehealth consultations, critical care

G0508, G0509

Pulmonary Care: Phone evaluation and management

99441, 99442, 99443

Pulmonary Care: Rehabilitation

94625, 94626, G0424

Pulmonary Care: Transitional care management services

99495, 99496

Pulmonary Care: Advance care planning

99497, 99498

Pulmonary Care: Prolonged service

99354, 99355, 99356, 99357

Pulmonary Care: Ventilator management

94002, 94003, 94004, 94005

Pulmonary Care: Evaluate patient use of inhaler

94664

Cardiac Care: Phone evaluation and management

99441, 99442, 99443

Cardiac Care: Transitional care management services

99495, 99496

Cardiac Care: Advance care planning

99497, 99498

Cardiac Care: Prolonged service

99354, 99355, 99356, 99357

Cardiac Care: Cardiac rehab

93797, 93798, G0422, G0423

Cardiac Care: In-person ventricular assist device interrogation

93750

Stroke and Rehabilitation Care: Phone evaluation and management

99441, 99442, 99443

Physical Therapy Services

97161, 97162, 97163, 97164, 97110, 97112, 97116, 97150, 97530, 97535, 97542, 97750, 97755, 97760, 97761; G2061, G2062, G2063

Occupation Therapy Services

97165, 97166, 97167, 97168

Speech Therapy

92507, 92508, 92521, 92522, 92523, 92524, 92526

Aphasia Assessment

96105

Cancer Care: Phone evaluation and management

99441, 99442, 99443

Cancer care: Radiation oncology treatment management

77427

Dementia Care: Phone evaluation and management

99441, 99442, 99443, G0438, G0439

Dementia Care: Cognitive assessment and care plan services

99483

* Remains available until December 31, 2023

** Will expire at some point after the COVID-19 public health emergency is declared over

More resources

Medicare Coverage and Payment of Virtual Services exit disclaimer icon  (video) — from the Centers for Medicare & Medicaid Services

Current State Laws & Reimbursement Policies exit disclaimer icon  — from the National Policy Center - Center for Connected Health Policy

Last updated: March 25, 2022

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