Full ACP-billing for Audio-Only Encounters

Updated May 18, 2020 | By CAPC Staff

New Medicare Flexibilities introduced, including audio-only for “telehealth” on certain codes

On April 30, the Centers for Medicare and Medicaid Services (CMS) again expanded Medicare billing flexibilities for virtual encounters. The list of codes that can be billed for telehealth – both audio and video – has expanded, and some codes are now able to be billed at the full payment rate if completed by telephone (audio only).  Included in the telephone-only list are the advance care planning codes 99497 and 99498. Prior to this change, telephone calls were limited to the telephone encounter codes, which paid only a fraction of the full Medicare rate. The telephone-only ACP billing is retroactive to encounters from March 31. The full list of codes billable by telehealth and telephone is available here.

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