New CPT codes for Telehealth Services in 2018

Medicare pays for a limited number of Part B services furnished by a physician or practitioner to an eligible beneficiary via a telecommunications system. For eligible telehealth services, the use of a telecommunications system substitutes for an in-person encounter.

New CPT codes for Telehealth Services in 2018

List of Medicare Telehealth Services CPT codes

HCPCS codes G0425–G0427 – Telehealth consultations, emergency department or initial
inpatient 

HCPCS codes G0406–G0408 – Follow-up inpatient telehealth consultations furnished to
beneficiaries in hospitals or SNFs

CPT codes 99201–99215 – Office or other outpatient visits

CPT codes 99231–99233 Subsequent hospital care services, with the limitation of
1 telehealth visit every 3 days

CPT codes 99307–99310 -Subsequent nursing facility care services, with the limitation
of 1 telehealth visit every 30 days

HCPCS codes G0420 and -Individual and group kidney disease education services
G0421 

HCPCS codes G0108 and G0109 -Individual and group diabetes self-management training
services, with a minimum of 1 hour of in-person instruction to be furnished in the initial year training period to ensure effective injection training.

CPT codes 96150–96154 – Individual and group health and behavior assessment and
intervention

CPT codes 90832–90834 and 90836–90838 – Individual psychotherapy

HCPCS code G0459 – Telehealth Pharmacologic Management

CPT codes 90791 and 90792 – Psychiatric diagnostic interview examination

CPT codes 90951, 90952, 90954, 90955, 90957, 90958, 90960, and 90961 – End-Stage Renal Disease (ESRD)-related services included in the monthly capitation payment

CPT code 90963 – End-Stage Renal Disease (ESRD)-related services for home dialysis per full month, for patients younger than 2 years of age to include monitoring for the adequacy of nutrition,
assessment of growth and development, and counseling
of parents

CPT code 90964 – End-Stage Renal Disease (ESRD)-related services for home dialysis per full month, for patients 2-11 years of age to include monitoring for the adequacy of nutrition, assessment
of growth and development, and counseling of parents

CPT code 90965 – End-Stage Renal Disease (ESRD)-related services for home dialysis per full month, for patients 12-19 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents 

More List of Teleheath Services CPT and HCPCS G codes

CPT code 90966 – End-Stage Renal Disease (ESRD)-related services for home dialysis per full month, for patients 20 years of age and older

CPT code 90967 – End-Stage Renal Disease (ESRD)-related services for dialysis less than a full month of service, per day; for patients younger than 2 years of age (effective for services
furnished on and after January 1, 2017)

CPT code 90968 – End-Stage Renal Disease (ESRD)-related services for dialysis less than a full month of service, per day; for patients 2-11 years of age (effective for services furnished
on and after January 1, 2017)

CPT code 90969 – End-Stage Renal Disease (ESRD)-related services for dialysis less than a full month of service, per day; for patients 12-19 years of age (effective for services furnished
on and after January 1, 2017)

CPT code 90970 – End-Stage Renal Disease (ESRD)-related services for dialysis less than a full month of service, per day; for patients 20 years of age and older (effective for services furnished on and after January 1, 2017)

               

HCPCS code G0270 and CPT codes 97802–97804 – Individual and group medical nutrition therapy 

CPT code 96116 – Neurobehavioral status examination

HCPCS codes G0436, G0437 and CPT codes 99406, 99407 – Smoking cessation services

HCPCS codes G0396 and G0397 – Alcohol and/or substance (other than tobacco) abuse structured assessment and intervention services

HCPCS code G0442 – Annual alcohol misuse screening, 15 minutes

HCPCS code G0443 – Brief face-to-face behavioral counseling for alcohol misuse,
15 minutes

HCPCS code G0444 – Annual depression screening, 15 minutes

HCPCS code G0445 – High-intensity behavioral counseling to prevent sexually transmitted infection; face-to-face, individual, includes: education, skills training and guidance on how to change
sexual behavior; performed semi-annually, 30 minutes

HCPCS code G0446 -Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes

HCPCS code G0447 – Face-to-face behavioral counseling for obesity, 15 minutes

CPT code 99495 – Transitional care management services with moderate medical decision complexity (face-to-face visit within 14 days of discharge)

CPT code 99496 – Transitional care management services with high medical decision complexity (face-to-face visit within 7 days of discharge)

CPT code 99497 – Advance Care Planning, 30 minutes (effective for services furnished on and after January 1, 2017)

CPT code 99498 – Advance Care Planning, additional 30 minutes (effective for services furnished on and after January 1, 2017)

CPT code 90845 – Psychoanalysis

CPT code 90846 – Family psychotherapy (without the patient present)

CPT code 90847 – Family psychotherapy (conjoint psychotherapy) (with patient present)

CPT code 99354 – Prolonged service in the office or other outpatient setting requiring direct patient contact beyond the usual service; first hour

CPT code 99355 – Prolonged service in the office or other outpatient setting requiring direct patient contact beyond the usual service; each additional 30 minutes

CPT code 99355 – Prolonged service in the office or other outpatient setting requiring direct patient contact beyond the usual service; each additional 30 minutes

CPT code 99356 – Prolonged service in the inpatient or observation setting requiring unit/floor time beyond the usual service; first hour (list separately in addition to code for inpatient evaluation
and management service)

CPT code 99357 – Prolonged service in the inpatient or observation setting requiring unit/floor time beyond the usual service; each additional 30 minutes (list separately in addition to code for
prolonged service)

HCPCS code G0438 – Annual Wellness Visit, includes a personalized prevention plan of service (PPPS) first visit

HCPCS code G0439 – Annual Wellness Visit, includes a personalized prevention plan of service (PPPS) subsequent visit

HCPCS code G0508 – Telehealth Consultation, Critical Care, initial, physicians typically spend 60 minutes communicating with the patient and providers via telehealth (effective for services furnished on and after January 1, 2017)

HCPCS code G0509 – Telehealth Consultation, Critical Care, subsequent, physicians typically spend 50 minutes communicating with the patient and providers via telehealth (effective for services furnished on and after January 1, 2017)

New CPT and HCPCS G codes in 2018 for Telehealth Services

CMS is proposing to pay for new telehealth services. There will be new CPT codes going to get add in the list of telehealth services.

  • HCPCS code G0296: Visit to determine low dose computed tomography eligibility
  • CPT code 90785: Interactive complexity
  • CPT codes 96160 and 96161: Health risk assessment
  • HCPCS code G0506: Care planning for chronic care management
  • CPT codes 90839 and 90840: Psychotherapy for crisis

Referral:

https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/TelehealthSrvcsfctsht.pdf

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