New in 2019: Medicare Payment for Communication Technology-Based Services

In the Final Rule for the 2019 Medicare Physician Fee Schedule, the Centers for Medicare & Medicaid Services (CMS) introduced two new Healthcare Common Procedure Coding System (HCPCS) codes to report the use of communication technology-based services. The services described by the new codes include a brief virtual check-in (HCPCS code G2012) and remote evaluation of recorded video or still images (HCPCS code G2010). To be payable by Medicare, the virtual check-in and remote evaluation of images must be provided by the billing practitioner and not clinical staff.

The virtual check-in (G2012) may be provided using real-time audio telephone interactions in addition to synchronous or two-way audio interactions that are enhanced using video or other types of data transmission. Any communication sent via email, text or voicemail is not considered a virtual check-in. The remote evaluation of images service (G2010) may be used to determine if a visit is needed after a patient submits video or still images for the physician to review.

In addition, CMS finalized coding and payment for remote interprofessional consultations between physicians reported with CPT® codes 99446-99449, 99451 and 99452. CMS’s stated goals of paying for the technology-based services include increasing efficiency for patients and providers by eliminating unnecessary visits and travel to physician offices and reducing overall costs of care to the patient.

For more guidance and information on how to bill for these services visit: Medicare Finalizes Payment for Communication Technology-Based Services: A Fact Sheet