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Non face-to-face telephone services

Evaluation and management services by telephone can be conducted by physicians and nonphysician
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At this time, we support and encourage you to provide care for new and established patients through any means (telephone, video or in person), from any location (home or office) and at any time, as long as the care is clinically appropriate, properly documented and follows appropriate billing procedures.

Evaluation and management services by telephone can be conducted by physicians and nonphysician health care professionals (as categorized in DOWC Rule 16-3).

  • Telephone calls can be used only with initial or established patients.
  • To be billable, the audio call must be a minimum of 5 minutes.
  • The medical record documentation must support the code.

Billing codes

These codes are available for telephone E&M services provided by a physician or nonphysician practitioner to a new or established patient, parent or guardian.

99441 5-10 minutes of medical discussion with a physician
99442 11-20 minutes of medical discussion with a physician
99443 21-30 minutes of medical discussion with a physician

98966 5-10 minutes of medical discussion with a nonphysician practitioner
98967 11-20 minutes of medical discussion with a nonphysician practitioner
98968 21-30 minutes of medical discussion with a nonphysician practitioner


Documentation

The medical record documentation for the phone call should specify:

  • The amount of time and date of service.
  • The patient, family member or health care provider talked to.
  • The specific recommendations, assessment and/or decisions made during the conversation.

Telephone or online services may be billed even if conducted within the one-day and seven-day timelines listed in CPT®.

Please note that triage calls for COVID-19 (coronavirus) screening before initial evaluations are not payable when conducted by schedulers, medical assistants or nurses. Screening calls are considered part of the exam visit.

For billing and coding assistance, contact billingsuccess@pinnacol.com or 303.361.4940.

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