CPT codes updated to allow doctors to bill for new telehealth technologies

Doctor on computer
New codes will allow doctors to bill for remote patient monitoring and internet consulting. (Getty/Vladdeep)

Technology is changing the way doctors and patients interact and the latest CPT codes have been updated to keep pace.

The American Medical Association (AMA) yesterday released the 2019 Current Procedural Terminology (CPT) code set and it includes new codes to allow doctors to bill for remote patient monitoring and internet consulting.

The AMA said it included updates to the CPT codes, which are used by insurers to help determine reimbursement for doctors and other providers for medical, surgical and diagnostic services, to reflect new technological and scientific advancements.

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“The latest annual changes to the CPT code set reflect new technological and scientific advancements available to mainstream clinical practice, and ensure the code set can fulfill its trusted role as the health system’s common language for reporting contemporary medical procedures, AMA President Barbara L. McAneny, M.D., said in an announcement.

There are 335 code changes in the new edition of the code set. They include three new codes for remote patent monitoring that allow doctors to connect with their patients at home and gather data for care management and coordination. There are also two new interprofessional internet consultation codes added for the use of nonverbal communication technology to coordinate patient care between a consulting and treating physician.

The inclusion of new codes for remote patient monitoring and internet consulting was welcomed by ACT, The App Association, a trade group that represents app companies and information technology firms. “[They] represent an important step forward in bringing digital health tools into the delivery of care, as well as in improving patient outcomes and reducing barriers to care,” the group said in an emailed statement to Fierce Healthcare.

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The AMA is urging the Centers for Medicare & Medicaid Service to adopt the new codes and designate the related services for payment under federal health programs in 2019. “Medicare’s acceptance of the new codes would signal a landmark shift to better support physicians participating in patient population health and care coordination services that can be a significant part of a digital solution for improving the overall quality of medical care,” said McAneny.

ACT, The App Association said it will continue to work through the Connected Health Initiative to ensure that the Medicare program accepts these new codes into the Physician Fee Schedule.

Other CPT changes for 2019 include new and revised codes for skin biopsy, fine needle aspiration biopsy, adaptive behavior analysis and central nervous system assessments including psychological and neuropsychological testing. 

The new codes, used by coders and billers, are effective as of Jan. 1, 2019. The AMA released its new edition four months ahead to give time to incorporate the new code changes.

In June, nearly 50 health IT stakeholders called on CMS to expand reimbursement for remote monitoring services in its next physician payment rule, expected to be finalized this fall.

The proposed physician fee schedule released in July would reimburse physicians for certain virtual interactions, a move that some see as a significant first step in overcoming the telehealth payment obstacle. The proposed rule includes several new proposals to pay physicians for virtual check-ins and reviewing patient photos or videos using asynchronous or “store-and-forward” transmission.

CMS also proposed adding new billing codes for “prolonged preventative services,” along with three new remote monitoring reimbursement codes.

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