Medicare Adds Telemedicine Codes

The newly adopted 2018 Medicare Physician Fee Schedule has added a few new codes to the list of telehealth services Medicare will cover. They are:

  • HCPCS code G0296 — screening for lung cancer with low-dose computed tomography
  • HCPCS code G0506 — add-on code for chronic care management planning
  • CPT code 90785 — psychotherapy add-on code for interactive complexity
  • CPT codes 96160 and 96161 — risk assessment for patient/caregiver
  • CPT codes 90839 and 90840 — psychotherapy for crisis

In addition, under the new fee schedule, Medicare:

  • Has deleted the required reporting of telehealth modifier GT “to reduce administrative burden for practitioners,” and
  • Will pay separately for CPT code 99091, which describes certain remote patient monitoring. The full definition is of 99091 is: Collection and interpretation of physiologic data (e.g., ECG, blood pressure, glucose monitoring) digitally stored and/or transmitted by the patient and/or caregiver to the physician or other qualified health care professional, qualified by education, training, licensure/regulation (when applicable) requiring a minimum of 30 minutes of time.

In the PFS proposed rule, the Centers for Medicare & Medicaid Services sought comments on ways to further expand access to telehealth services within its current statutory authority and says it “will consider this input in future rulemaking.”

For more information about Medicare coverage of telemedicine, see the CMS Telehealth Services fact sheet (not yet updated to the changes to the 2018 PFS).

Read other highlights from the 2018 PFS in this Nov. 2 press release from CMS. You can dig deeper into what’s new for 2018, along with next steps under the Medicare Access and CHIP Reauthorization Act (MACRA), at TMA’s popular annual Medicare update seminar. Register now for the half-day seminar, Back to the Future of Medicare, which runs Nov. 14-Dec. 7 at a city near you, or for the live webcast on Dec. 7. Also, visit the TMA Medicare webpage for news and information.

Published Nov. 7, 2017

TMA Practice E-Tips main page

Last Updated On

November 08, 2017

Related Content

Medicare | Telemedicine