Welcome to the MCMS Telemedicine Reference Page

Last updated 3.27.2020

Below are commonly used codes for Telemedicine Billing

99441: Telephone E/M service; 5-10 minutes of medical discussion

99442: 11-20 minutes of medical discussion        

99443: 21-30 minutes of medical discussion

G2012 Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services; 5-10 minutes of medical discussion


99421: Online digital E/M service5-10 minutes of medical discussion

99422: Online digital E/M service11- 20 minutes of medical discussion

99423: Online digital E/M service 21-30 minutes of medical discussion


Aetna:

Beginning March 6, 2020, Aetna will offer zero co-pay for covered telemedicine visits for any reason for 90 days. We will waive the cost share for all video and telephone visits through the Aetna-covered Teladoc offerings and in-network providers delivering synchronous virtual care (live video-conferencing) for all Commercial plan designs*. Self-insured plan sponsors can opt-out of this program at their discretion.

Refer to Aetna website for current information


Excellus:

Cost sharing waved Modifiers: 95 for commercial; GT for Medicare Advantage

Use E/M codes according to criteria: 99441**, 99442**, 99443**, 99421**, 99422**, 99423**,G2012**


Refer to provider Bulletin for updates



MVP:

Cost sharing waved Modifiers: 95 for commercial; GT for Medicare Advantage

Use E/M codes according to criteria: 99441, 99442, 99443 – Commercial and Medicaid

G2012 – Commercial and Medicare Advantage - refer to MVP for Medicare Advantage contracts.

Refer to MVP Fast Fax for updates

NYS Medicaid:

99441,99442, 99443, 99211GQ new or established patients

HHS Fact Sheet: Telehealth Flexibilities and Resources and the COVID-19 Public Health Emergency | HHS.gov


United Healthcare:

99421, 99422, 99423

https://www.uhcprovider.com/en/resource-library/news/provider-telehealth-policies.html

for specific questions you can reach out to your provider rep or to John Graves John_Graves@uhc.com

Powered by Wild Apricot Membership Software