Billing for Phone/Audio-only appointment

[Psych19]

Within my institution, we've been getting some information from our billing educators that we are no longer allowed to bill E/M follow-up codes (e.g. 99213, 99214 or 99215) for telephonic visits since the PHE ended. I'm aware these codes are still allowed for televideo. We're now being told, when a visit is audio-only without video, that we need to use telephonic visit codes (e.g., 99441, 99442, or 99443) or psychotherapy without E/M codes (e.g., 90832, ect.), AND that we cannot use psychotherapy add-on codes with telephonic visit codes.

Does this sound right?

I'm curious if others are being given this direction. Our billing department seems to be open to the possibility that they could be wrong about this, but they're looking for documentation that clarifies what billing practices are now allowed for phone visits in behavioral health.

I think we can all agree that televideo visits are superior to telephonic visits and we should be pushing for these. I'm just looking for information about what's allowed with respect to billing.

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[PsyDr]

I don't think that's right.

1) 99441-99442 is for phone calls that are initiated by the patient.

2) I believe the technically correct answer is to use 99213 + modifier 93. That's a new modifier, which has not been valued by CMS yet.

 

[randomdoc1]

The bigger question is what each insurance company will honor it--that dictates if the hospital and/or you get paid. If modifier 93 is not valued by CMS yet, then most other insurances will follow that lead. The telephonic only codes, from personal experience, are also lower paying by quite a bit and worth fewer RVUs. I mean, IRL could you do a telephone visit and bill it like we used to with telehealth? Sure. The onus is on the insurance company to audit and investigate if that actually happened. But I generally try to play it safe and push for safe in person or audio visual. But that's just how I approach things : /.