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Coding overview

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In many cases, coding for telemedicine services is done using the corresponding codes for an in-person E/M visit, but with the 95 modifier (synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system) appended. Place of service should be designated as “02”. Some private payers permit telemedicine visits for new patients, but not with the standard new patient CPT codes. Instead, they require billing with code 99499 (unlisted evaluation and management code) with the place of service “02”. This may be associated with lower reimbursement than an in-person new patient visit. Medicare used to require modifier GT for synchronous visits and GQ for asynchronous visits, but this has been eliminated as of January 2018. Instead, the place of service code should also be designated as “02”. Alternatively, the CPT code 99444 or 98969 can be utilized to designate an online evaluation. In this case, no modifier would be necessary, but the place of service should still be designated as “02”.