Telehealth billing coding

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Does anyone know how to utilize these codes and can 90833 be added to the new E&M codes?

Effective January 1, 2025:

• ForwardHealth covers new telehealth CPT codes 98000–98015 for E/M services. Once the systems updates are complete, ForwardHealth will automatically process any suspended claims. No other action is required.
• The AMA end-dated E/M telehealth CPT codes 99441, 99442, and 99443 December 31, 2024.
• Per AMA official guidance:
  • CPT codes 99202–99205 and 99212–99215 are no longer used with telehealth place of service (POS) codes 02 (Telehealth Provided Other Than in Patient's Home) and 10 (Telehealth Provided in Patient's Home).
  • POS codes 02 and 10 for 99202–99205 and 99212–99215 were end-dated December 31, 2024. If a claim was previously denied, providers should refer to the new E/M telehealth CPT codes 98000–98015.
• ForwardHealth has updated coverage policy for office or outpatient E/M services. This mirrors official AMA changes to Appendix P of the 2025 CPT codebook (with CPT codes that may be used for synchronous real-time interactive audio-visual telemedicine services).

Why in the heck, would AMA get rid of what worked, POS 02 +99213 or 92214 or 99215 and the GT modifier? The AMA truly hates physicians.

I've been billing these POS 02 and GT modifiers with the usual 99213-5 in follow ups consistently (except medicare as 95 modifier).

If any of my insurance companies implemented this change, and are paying less, I could be bankrupted if they pursue claw backs later.

How wide spread is this 98000-98015 scat?

Addendum:
I've got calls out to the main insurance company that keeps my lights on. Waiting on call backs. Best guess calculations, from the total rvu changes, might cost me $55 / 99214 encounter. I've got 60-70% of my follow ups as telemedicine either by patient choice, work conflicts, or truly geographic distance. This could be brutal.

 

[randomdoc1]

Why in the heck, would AMA get rid of what worked, POS 02 +99213 or 92214 or 99215 and the GT modifier? The AMA truly hates physicians.

I've been billing these POS 02 and GT modifiers with the usual 99213-5 in follow ups consistently (except medicare as 95 modifier).

If any of my insurance companies implemented this change, and are paying less, I could be bankrupted if they pursue claw backs later.

How wide spread is this 98000-98015 scat?

Addendum:
I've got calls out to the main insurance company that keeps my lights on. Waiting on call backs. Best guess calculations, from the total rvu changes, might cost me $55 / 99214 encounter. I've got 60-70% of my follow ups as telemedicine either by patient choice, work conflicts, or truly geographic distance. This could be brutal.

so far, two payers have implemented the two codes, both Medicaid HMO plans. Yes, some of the 99214 with AV modifiers have gotten clawbacks.

What I have seen on the payer websites so far
-straight Medicare--sticking to billing as usual
-United/Optum commercial or self purchased insurance (non-Medicaid)--sticking to billing as usual
-United/Optum Medicaid--implementing new codes

Very confusing but it's starting to clear up.

BCBS seems geo specific.

 

[JustPushTheButton]

Just want to confirm this is happening in Michigan since July 1st of 2025.

For BCBS and BCN 99214 used to reimburse 124.45 now its reimbursing $105(with code 98006). I Initially thought that i could not use 90833 with the new telehealth billing code but now i am unsure. Will reprocess my claims and give you guys an update... all my telehealth 99214+90833 were rejected.

I am unsure if 90792 for psych evaluations remote are still covered fully. Can someone confirm is 90792 is still covered virtually?

 

[randomdoc1]

I have seen the 90792 come through fine for all payers so far. Even the ones that started using 98006.

 

[allantois]

BCBS is rejecting 90792 from virtual visits here

 

[MedMan80]

BCBS is rejecting 90792 from virtual visits here

How about 99203 + 90833?

 

[allantois]

How about 99203 + 90833?

They are not accepting 99 codes for tele visits. I have not tried to bill a 90833 with the new codes as I didn’t think I could

 

[randomdoc1]

They are not accepting 99 codes for tele visits. I have not tried to bill a 90833 with the new codes as I didn’t think I could

give it a shot and report back? lol, now with your new avatar, I hear your words spoken in the voice of a parrot!

 

[Dr. M Toboggan]

BCBS is rejecting 90792 from virtual visits here

Yikes. What state are you in?

 

[allantois]

Yikes. What state are you in?

FL

 

[MedMan80]

They are not accepting 99 codes for tele visits. I have not tried to bill a 90833 with the new codes as I didn’t think I could

So what do they expect one to bill for initial visit codes? They're tele only codes? What do they pay for evals

 

[allantois]

So what do they expect one to bill for initial visit codes? They're tele only codes? What do they pay for evals

I've used 98003 which pays around the same

 

[JustPushTheButton]

Just wanted to provide an update with what's going on with Blue cross blue shield in Michigan. You can bill 98006 together with 90833 for remote patients. While 90833 is still covered at the same rate, 98006 reimburses less than 99214. Additionally, 90792 remains covered for remote patients Seems like this was just a way for blue cross blue shield to reimburse providers less..