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Best practice guide

Telehealth for emergency departments
For providers Best practice guides Telehealth for emergency departments

Billing for telehealth in emergency departments

During the COVID-19 public health emergency, additional emergency care services are covered by Medicare as telehealth. Other related services, such as remote patient monitoring and e-consults, are not considered telehealth for billing purposes, but are reimbursable.

Medicare billing guidance

Below are common codes used to bill for these services. Note: some of these services are temporarily covered during the COVID-19 public health emergency.

Category Billing and telehealth CPT codes

Emergency department

Evaluation and management: 99281, 99282, 99283, 99284, 99285

Critical care

First hour: 99291

Additional 30 min: 99292

Observation services

Discharge: 99217

Initial: 99218, 99219, 99220

Subsequent: 99224, 99225, 99226

Observation / discharge on same day: 99234, 99235, 99236

Hospital discharge day management

Less than 30 minutes: 99238

30 minutes or more: 99239

E-consults (interprofessional consults)

Verbal and written report: 99446, 99447, 99448, 99449

Written report only: 99451

Remote patient monitoring

99453, 99454 — 16 day minimum monitoring requirement is waived during the COVID-19 public health emergency (2 days minimum)

99457, 99458, 99091

Tip: Services provided virtually while the provider and patient are in the same location — for instance, over a tablet from different rooms within a hospital — are not billed as telehealth.

For more details about billing and reimbursement:

  • See the complete list of telehealth services covered by Medicare during the public health emergency from the Centers for Medicare & Medicaid Services

Medicaid

While each state is different, most have expanded coverage for telehealth due to COVID-19. Many are now matching Medicare’s telehealth coverage. Check your state’s current laws and reimbursement policies exit disclaimer icon  to see what is covered. For updates on COVID-19 reimbursement and related Medicaid codes and procedures for your state, see:

Private insurance

Many code changes for COVID-19 care cover telehealth and include specific information for visits that are video- or audio-only. It is important to note that most states distinguish between reimbursement standards for permanent telehealth policies and temporary COVID-19 reimbursement policies. For tips on coding private insurance claims, see:

Have a question?

Contact the staff at the regional telehealth resource center exit disclaimer icon  that’s closest to you for help with your telehealth program.

Last updated: June 3, 2021

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