| Action | Patient education & device calibration | Patient education & device calibration | Subsequent Activity: Collect and interpret monthly BP readings (no additional E/M service associated) | |
|---|---|---|---|---|
| Who is performing | Physician / QHP | Physician / QHP | Physician / QHP | |
| Applicable CPT Code(s) | E/M Telehealth | Telephone Visit New and Established Patients | Included in E/M | 99474 Self-measured blood pressure using a device validated for clinical accuracy; separate self-measurements of two readings one minute apart, twice daily over a 30-day period (minimum of 12 readings), collection of data reported by the patient and/or caregiver to the physician or other qualified health care professional, with report of average systolic and diastolic pressures and subsequent communication of a treatment plan to the patient |
| New Patient | 99441 (5-10 min) Payor guidelines may vary 99442 (11-20 min) Payor guidelines may vary 99443 (21-30 min) Payor guidelines may vary | |||
| 99201 (typical time 10 min) 99202 (typical time 20 min) 99203 (typical time 30 min) 99204 (typical time 45 min) 99205 (typical time 60 min) | ||||
| Established Patient | ||||
| 99212 (typical time 10 min) 99213 (typical time 15 min) 99214 (typical time 25 min) 99215 (typical time 40 min) | ||||
| Applicable ICD-10 CM codes | Non-COVID-19 patient: Code applicable ICD-10-CM diagnoses COVID-19 patient: Code applicable ICD-10-CM diagnoses, add applicable COVID-19 focused diagnosis Asymptomatic, no known exposure, results unknown or negative Z11.59 Contact with COVID-19, Suspected exposure Z20.828 U07.1, COVID-19. | |||
| Place of Service (POS) | 11 - Physician Office 19 - Off Campus Outpatient Hospital 20 - Urgent Care Facility 22 - On Campus Outpatient Hospital | 11 - Physician Office | 11 - Physician Office | |
| Notes | 1 CMS requires use of modifier 95 for telehealth services; other payors may require its use 2 Individual states (through Executive Order) or payors may permit use of E/M codes with audio-only encounters. 3 CMS will permit reporting of telehealth E/M office or other outpatient visits based on time or Medical Decision Making (MDM). | Do not report 99474 more than once per calendar month. | ||
Summarize with
