Replacement codes for on-call medical advice

[sammywammy]

We used to bill on-call provider calls using 99441–99443 for things like med advice or calling in scripts. Now that those are gone, I can't figure out the right CPT to use. Is anyone else billing these under a new code or modifier now?

 

[Wonderful-Fortune5521]

Many moved to G2012 or 99421–99423 if the call meets time and service rules. Some also use 99358 for extra time if it connects to future care. Might be worth checking with your payer to be sure. They don't all treat these the same.

 

[mbcer218]

We used to bill on-call provider calls using 99441–99443 for things like med advice or calling in scripts. Now that those are gone, I can't figure out the right CPT to use. Is anyone else billing these under a new code or modifier now?

Yeah, those were deleted start of the year! CPT introduced 98008-98015 for new audio-only E/M and 98016 as a brief service code, replacing Medicare's G2012.

But you have to keep in mind that while CPT has these new codes, Medicare generally does not recognize 98008-98015 for audio-only E/M services. Instead, for Medicare patients, you'll still need to use the existing E/M codes 99202-99215 and append modifier 93 to indicate it was an audio-only encounter. This applies if the provider is capable of audio-video but the patient isn't, or declines. It's also always verify with other payers, as their policies can vary!!

 

[The Flashhh]

If payers still expect 24/7 access, but stripped the codes for those after-hours calls, aren't they basically demanding free labor from providers? How are we supposed to stay compliant and compensated?