Maximize Revenue by Billing for Non-Face-to-Face Services

professional medical billing services

In November of 2018 CMS released new HCPCS codes that allow for provider to begin billing for non-face-to-face services on January 1st, 2019. Some of these services, you are likely already doing, but are you getting paid for them?

What are the codes and requirements?

G2010

This code covers the remote evaluation of recorded videos and/or pictures submitted by an established patient. You may have heard the phrase “store and forward” at some point in recent years, this allows practitioners to be reimbursed for these types of services. Follow-up can be done virtually via Patient Portal, secure text, or video and does not have to be face-to-face or verbal, but has to be done within 24 business hours. There are a few restrictions to billing for this code, however. You can’t bill for this service if you have billed for a related E&M service within the previous 7 days nor lead to a billed service within 24 hours.

According to CMS:

“Remote evaluation of recorded video and/or images submitted by the patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related E/M service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment.”

G2012

This code has been named “Brief Communication Technology-Based Service, e.g. Virtual Check-In.” Services that qualify as a Virtual Check-In include any real-time telephone, or video conferencing performed between and established patient and the billing provider, normally 5-10 minutes long. It cannot be done by a clinical staff member. According to CMS the requirements are: “audio-only real-time telephone interactions in addition to synchronous, two-way audio interactions that are enhanced with video or other kinds of data transmission.” The same time restraints that are in place for G2010, also apply to G2012.

According to CMS:

“Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified healthcare professional who can report evaluation and management [E/M] services, provided to an established patient, not originating from a related E/M service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion.”

HIPAA

The technology used for these communications must be secure and HIPAA compliant. Do not use Skype, Facetime, or SMS Text Messaging.

Patient Consent

Since there is a co-payment for these billable services, patient consent, verbal or written, is required before performing the services and must be noted in the patient’s record for each occasion.

Don’t Miss Out

If you are already performing these services, it make sense to bill for them. If you aren’t already performing these services, it is a good time to start! This is a great benefit to your patients since it allows for more a convenient and pleasant healthcare experience!

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