Four virtual visit options for treating patients who can't do video

Patients may be leery about coming into your office during the COVID-19 pandemic, no matter how many safety measures you take. Here are four ways to treat them remotely even if they don’t have the equipment or technological know-how to do video visits:

1. Online digital evaluation and management (E/M) services, or “e-visits” (CPT 99421-99423): Back-and-forth, not real-time (asynchronous) communication, usually done through a secure email or patient portal.

2. Virtual check-ins (HCPCS G2012): Synchronous brief communication by phone or other device to determine if in-person care is needed.

3. Remote evaluation (HCPCS G2010): Evaluation of recorded video or images (store and forward).

4. Telephone E/M services (CPT 99441-99443): Diagnosis and management of a patient's problem over the phone. Medicare has agreed to temporarily reimburse these services at the same rates as if they were performed in-person and increased the number of services that can be performed over the phone.

The following rules apply to all four types of services:

• They are not limited to rural settings; no location restrictions.
• Medicare covers them (check with commercial payers before billing).
• Time-based codes must have time documented in the note.
• They can be provided to new or established patients during the public health emergency.
• They must be patient-initiated. The patient calls the practice or sends a message requesting a new appointment, or the patient agrees to change a previously scheduled face-to-face visit to a virtual encounter.
• They may result in co-pay or cost-sharing; patient consent must be documented. If your organization does not use a general consent updated annually to cover all of these services, then consent should be obtained prior to each service rendered.
• Information that can be stored and shared (for example, text messages, recorded video, or images) must be stored in the patient's electronic health record. Best practice is to include it in the encounter note.

Read the full FPM article: “Operationalizing Virtual Visits During a Public Health Emergency."