Telemedicine visits are conducted virtually and clinicians must utilize both video and audio to bill these visits (not audio only), and need to be 2-way communication. There is a requirement that patients consent to telemedicine services, at least verbally. During the COVID-19 pandemic telemedicine visits began to be widely covered for reimbursement. They continue to be covered after the pandemic, but, in the future, requirements for telemedicine visits are subject to change, so need to be monitored for updates.
Telemedicine visits are billed the same as outpatient new (CPT 99202-99205) or established (99211-99215) clinic visits, with the same exact billing criteria for medical decision-making and time-based billing. However, some states may not cover new visits. Unless temporary exceptions are granted:
- The provider needs to be located in the same state as the patient or
- Needs to be licensed in the state where the care is being provided to the patient and
- The patient needs to be home during the telemedicine visit.
Since regulations for telemedicine are in a continued state of flux, check the current regulations regarding these considerations.