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Payment Increases for Audio-only Visit Codes (99441-99443)

May 06, 2020

McDermott+Consulting

Through an interim final rule released on April 30, 2020, the Centers for Medicare and Medicaid Services (CMS) increased payment for telephone evaluation and management codes (99441-99443) to match payments for similar outpatient visit codes. This change increases payment for these services from a range of about $14 – $41 to about $46 – $110. The increased payments are retroactive to March 1, 2020.

Under current Medicare telehealth policy, reporting office/outpatient visits via telehealth requires the use of audio-visual technology. For a variety of reasons, including patient access and comfort with the technology, clinicians are often not able to provide evaluation and management (E/M) codes using the required technology. Stakeholders have been urging the agency to waive the audio-visual technology requirement for E/M services. Raising the reimbursement rates for telephone-only codes provides a solution to this problem. While generally pleased with this result, stakeholders are requesting further clarification from the agency on reporting and documentation requirements for the telephone visit codes. In addition, stakeholders continue to seek additional clarification regarding the use of audio only visits for risk adjustment purposes.

Other telehealth flexibilities implemented through this interim final rule are summarized here.

Stay up-to-date on COVID-19 emerging issues through the McDermottPlus Coronavirus Resource Center or the McDermott, Will & Emery Coronavirus Resource Center.

 

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For more information visit the McDermottPlus Payment Innovation Resource Center or contact Sheila Madhani at 202-204-1459/smadhani@mcdermottplus.com, Mara McDermott at 202-204-1462/mmcdermott@mcdermottplus.com or Rachel Stauffer at 202-204-1460/rstauffer@mcdermottplus.com.

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