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What is telehealth and what Medicare related healthcare services are available through telehealth?


The 2020 Medicare & You handbook provided the following description of "telehealth":

"Medicare covers services like office visits, psychotherapy, consultations, and certain other medical or health services provided by an eligible provider who isn’t at your location using an interactive, two-way telecommunications system (like real-time audio and video). These services are available in rural areas, under certain conditions, but only if you’re located at: a doctor’s office, hospital, critical access hospital, Rural Health Clinic, Federally Qualified Health Center, hospital-based dialysis facility, skilled nursing facility, or community mental health center.

More recently, Medicare has expanded telehealth to include:
  • You can get certain telehealth services at renal dialysis facilities and at home.
  • You can get telehealth services for faster diagnosis, evaluation, or treatment of symptoms of an acute stroke no matter where you’re located.
  • If you have a substance use disorder [such as alchoholism] or a co-occurring mental health disorder, you can get telehealth services from home.
For most of these services, you’ll pay the same amount that you would if you got the services in person."

The Medicare & You handbook continues on to expand the geographically-limited concept telehealth noting that:

"Starting in 2020, Medicare Advantage Plans may offer more telehealth benefits than Original Medicare. These benefits will be available no matter where you’re located, and you can use them at home instead of going to a health care facility. Check with your plan to see what additional telehealth benefits are offered."

What services might be covered by telehealth?

The Centers for Medicare and Medicaid Services (CMS) provides the following list of services payable under the Medicare Physician Fee Schedule when furnished via telehealth or telemedicine.

LIST OF MEDICARE TELEHEALTH SERVICES
CY 2021   CY 2020
Code Short Descriptor   Code Short Descriptor
77427Radiation tx management x5   
90785Psytx complex interactive 90785Psytx complex interactive
90791Psych diagnostic evaluation 90791Psych diagnostic evaluation
90792Psych diag eval w/med srvcs 90792Psych diag eval w/med srvcs
90832Psytx w pt 30 minutes 90832Psytx pt&/family 30 minutes
90833Psytx w pt w e/m 30 min 90833Psytx pt&/fam w/e&m 30 min
90834Psytx w pt 45 minutes 90834Psytx pt&/family 45 minutes
90836Psytx w pt w e/m 45 min 90836Psytx pt&/fam w/e&m 45 min
90837Psytx w pt 60 minutes 90837Psytx pt&/family 60 minutes
90838Psytx w pt w e/m 60 min 90838Psytx pt&/fam w/e&m 60 min
90839Psytx crisis initial 60 min 90839Psytx crisis initial 60 min
90840Psytx crisis ea addl 30 min 90840Psytx crisis ea addl 30 min
90845Psychoanalysis 90845Psychoanalysis
90846Family psytx w/o pt 50 min 90846Family psytx w/o patient
90847Family psytx w/pt 50 min 90847Family psytx w/patient
90853Group psychotherapy   
90875Psychophysiological therapy   
90951Esrd serv 4 visits p mo <2yr 90951Esrd serv 4 visits p mo <2yr
90952Esrd serv 2-3 vsts p mo <2yr 90952Esrd serv 2-3 vsts p mo <2yr
90953Esrd serv 1 visit p mo <2yrs   
90954Esrd serv 4 vsts p mo 2-11 90954Esrd serv 4 vsts p mo 2-11
90955Esrd srv 2-3 vsts p mo 2-11 90955Esrd srv 2-3 vsts p mo 2-11
90956Esrd srv 1 visit p mo 2-11   
90957Esrd srv 4 vsts p mo 12-19 90957Esrd srv 4 vsts p mo 12-19
90958Esrd srv 2-3 vsts p mo 12-19 90958Esrd srv 2-3 vsts p mo 12-19
90959Esrd serv 1 vst p mo 12-19   
90960Esrd srv 4 visits p mo 20+ 90960Esrd srv 4 visits p mo 20+
90961Esrd srv 2-3 vsts p mo 20+ 90961Esrd srv 2-3 vsts p mo 20+
90962Esrd serv 1 visit p mo 20+   
90963Esrd home pt serv p mo <2yrs 90963Esrd home pt serv p mo <2yrs
90964Esrd home pt serv p mo 2-11 90964Esrd home pt serv p mo 2-11
90965Esrd home pt serv p mo 12-19 90965Esrd home pt serv p mo 12-19
90966Esrd home pt serv p mo 20+ 90966Esrd home pt serv p mo 20+
90967Esrd svc pr day pt <2 90967Esrd home pt serv p day <2
90968Esrd svc pr day pt 2-11 90968Esrd home pt serv p day 2-11
90969Esrd svc pr day pt 12-19 90969Esrd home pt serv p day 12-19
90970Esrd svc pr day pt 20+ 90970Esrd home pt serv p day 20+
92002Eye exam new patient   
92004Eye exam new patient   
92012Eye exam establish patient   
92014Eye exam&tx estab pt 1/>vst   
92507Speech/hearing therapy   
92508Speech/hearing therapy   
92521Evaluation of speech fluency   
92522Evaluate speech production   
92523Speech sound lang comprehen   
92524Behavral qualit analys voice   
92526Oral function therapy   
92550Tympanometry & reflex thresh   
92552Pure tone audiometry air   
92553Audiometry air & bone   
92555Speech threshold audiometry   
92556Speech audiometry complete   
92557Comprehensive hearing test   
92563Tone decay hearing test   
92565Stenger test pure tone   
92567Tympanometry   
92568Acoustic refl threshold tst   
92570Acoustic immitance testing   
92587Evoked auditory test limited   
92588Evoked auditory tst complete   
92601Cochlear implt f/up exam <7   
92602Reprogram cochlear implt <7   
92603Cochlear implt f/up exam 7/>   
92604Reprogram cochlear implt 7/>   
92607Ex for speech device rx 1hr   
92608Ex for speech device rx addl   
92609Use of speech device service   
92610Evaluate swallowing function   
92625Tinnitus assessment   
92626Eval aud funcj 1st hour   
92627Eval aud funcj ea addl 15   
93750Interrogation vad in person   
93797Cardiac rehab   
93798Cardiac rehab/monitor   
94002Vent mgmt inpat init day   
94003Vent mgmt inpat subq day   
94004Vent mgmt nf per day   
94005Home vent mgmt supervision   
94664Evaluate pt use of inhaler   
95970Alys npgt w/o prgrmg   
95971Alys smpl sp/pn npgt w/prgrm   
95972Alys cplx sp/pn npgt w/prgrm   
95983Alys brn npgt prgrmg 15 min   
95984Alys brn npgt prgrmg addl 15   
96105Assessment of aphasia   
96110Developmental screen w/score   
96112Devel tst phys/qhp 1st hr   
96113Devel tst phys/qhp ea addl   
96116Nubhvl xm phys/qhp 1st hr 96116Neurobehavioral status exam
96121Nubhvl xm phy/qhp ea addl hr   
96125Cognitive test by hc pro   
96127Brief emotional/behav assmt   
96130Psycl tst eval phys/qhp 1st   
96131Psycl tst eval phys/qhp ea   
96132Nrpsyc tst eval phys/qhp 1st   
96133Nrpsyc tst eval phys/qhp ea   
96136Psycl/nrpsyc tst phy/qhp 1st   
96137Psycl/nrpsyc tst phy/qhp ea   
96138Psycl/nrpsyc tech 1st   
96139Psycl/nrpsyc tst tech ea   
   96150Assess hlth/behave init
   96151Assess hlth/behave subseq
   96152Intervene hlth/behave indiv
   96153Intervene hlth/behave group
   96154Interv hlth/behav fam w/pt
96156Hlth bhv assmt/reassessment   
96158Hlth bhv ivntj indiv 1st 30   
96159Hlth bhv ivntj indiv ea addl   
96160Pt-focused hlth risk assmt 96160Pt-focused hlth risk assmt
96161Caregiver health risk assmt 96161Caregiver health risk assmt
96164Hlth bhv ivntj grp 1st 30   
96165Hlth bhv ivntj grp ea addl   
96167Hlth bhv ivntj fam 1st 30   
96168Hlth bhv ivntj fam ea addl   
96170Hlth bhv ivntj fam wo pt 1st   
96171Hlth bhv ivntj fam w/o pt ea   
97110Therapeutic exercises   
97112Neuromuscular reeducation   
97116Gait training therapy   
97129Ther ivntj 1st 15 min   
97130Ther ivntj ea addl 15 min   
97150Group therapeutic procedures   
97151Bhv id assmt by phys/qhp   
97152Bhv id suprt assmt by 1 tech   
97153Adaptive behavior tx by tech   
97154Grp adapt bhv tx by tech   
97155Adapt behavior tx phys/qhp   
97156Fam adapt bhv tx gdn phy/qhp   
97157Mult fam adapt bhv tx gdn   
97158Grp adapt bhv tx by phy/qhp   
97161Pt eval low complex 20 min   
97162Pt eval mod complex 30 min   
97163Pt eval high complex 45 min   
97164Pt re-eval est plan care   
97165Ot eval low complex 30 min   
97166Ot eval mod complex 45 min   
97167Ot eval high complex 60 min   
97168Ot re-eval est plan care   
97530Therapeutic activities   
97535Self care mngment training   
97542Wheelchair mngment training   
97750Physical performance test   
97755Assistive technology assess   
97760Orthotic mgmt&traing 1st enc   
97761Prosthetic traing 1st enc   
97802Medical nutrition indiv in 97802Medical nutrition indiv in
97803Med nutrition indiv subseq 97803Med nutrition indiv subseq
97804Medical nutrition group 97804Medical nutrition group
   99201Office/outpatient visit new
99202Office/outpatient visit new 99202Office/outpatient visit new
99203Office/outpatient visit new 99203Office/outpatient visit new
99204Office/outpatient visit new 99204Office/outpatient visit new
99205Office/outpatient visit new 99205Office/outpatient visit new
99211Office/outpatient visit est 99211Office/outpatient visit est
99212Office/outpatient visit est 99212Office/outpatient visit est
99213Office/outpatient visit est 99213Office/outpatient visit est
99214Office/outpatient visit est 99214Office/outpatient visit est
99215Office/outpatient visit est 99215Office/outpatient visit est
99217Observation care discharge   
99218Initial observation care   
99219Initial observation care   
99220Initial observation care   
99221Initial hospital care   
99222Initial hospital care   
99223Initial hospital care   
99224Subsequent observation care   
99225Subsequent observation care   
99226Subsequent observation care   
99231Subsequent hospital care 99231Subsequent hospital care
99232Subsequent hospital care 99232Subsequent hospital care
99233Subsequent hospital care 99233Subsequent hospital care
99234Observ/hosp same date   
99235Observ/hosp same date   
99236Observ/hosp same date   
99238Hospital discharge day   
99239Hospital discharge day   
99281Emergency dept visit   
99282Emergency dept visit   
99283Emergency dept visit   
99284Emergency dept visit   
99285Emergency dept visit   
99291Critical care first hour   
99292Critical care addl 30 min   
99304Nursing facility care init   
99305Nursing facility care init   
99306Nursing facility care init   
99307Nursing fac care subseq 99307Nursing fac care subseq
99308Nursing fac care subseq 99308Nursing fac care subseq
99309Nursing fac care subseq 99309Nursing fac care subseq
99310Nursing fac care subseq 99310Nursing fac care subseq
99315Nursing fac discharge day   
99316Nursing fac discharge day   
99324Domicil/r-home visit new pat   
99325Domicil/r-home visit new pat   
99326Domicil/r-home visit new pat   
99327Domicil/r-home visit new pat   
99328Domicil/r-home visit new pat   
99334Domicil/r-home visit est pat   
99335Domicil/r-home visit est pat   
99336Domicil/r-home visit est pat   
99337Domicil/r-home visit est pat   
99341Home visit new patient   
99342Home visit new patient   
99343Home visit new patient   
99344Home visit new patient   
99345Home visit new patient   
99347Home visit est patient   
99348Home visit est patient   
99349Home visit est patient   
99350Home visit est patient   
99354Prolong e&m/psyctx serv o/p 99354Prolonged service office
99355Prolong e&m/psyctx serv o/p 99355Prolonged service office
99356Prolonged service inpatient 99356Prolonged service inpatient
99357Prolonged service inpatient 99357Prolonged service inpatient
99406Behav chng smoking 3-10 min 99406Behav chng smoking 3-10 min
99407Behav chng smoking > 10 min 99407Behav chng smoking > 10 min
99441Phone e/m phys/qhp 5-10 min   
99442Phone e/m phys/qhp 11-20 min   
99443Phone e/m phys/qhp 21-30 min   
99468Neonate crit care initial   
99469Neonate crit care subsq   
99471Ped critical care initial   
99472Ped critical care subsq   
99473Self-meas bp pt educaj/train   
99475Ped crit care age 2-5 init   
99476Ped crit care age 2-5 subsq   
99477Init day hosp neonate care   
99478Ic lbw inf < 1500 gm subsq   
99479Ic lbw inf 1500-2500 g subsq   
99480Ic inf pbw 2501-5000 g subsq   
99483Assmt & care pln pt cog imp   
99495Trans care mgmt 14 day disch 99495Trans care mgmt 14 day disch
99496Trans care mgmt 7 day disch 99496Trans care mgmt 7 day disch
99497Advncd care plan 30 min 99497Advncd care plan 30 min
99498Advncd care plan addl 30 min 99498Advncd are plan addl 30 min
0373TAdapt bhv tx ea 15 min   
S9152Speech therapy, re-eval   
0362TBhv id suprt assmt ea 15 min   
G0108Diab manage trnper indiv G0108Diab manage trn per indiv
G0109Diab manage trn ind/group G0109Diab manage trn ind/group
G0270Mnt subs tx for change dx G0270Mnt subs tx for change dx
G0296Visit to determ ldct elig G0296Visit to determ ldct elig
G0396Alcohol/subs interv 15-30mn G0396Alcohol/subs interv 15-30mn
G0397Alcohol/subs interv >30 min G0397Alcohol/subs interv >30 min
G0406Inpt/tele follow up 15 G0406Inpt/tele follow up 15
G0407Inpt/tele follow up 25 G0407Inpt/tele follow up 25
G0408Inpt/tele follow up 35 G0408Inpt/tele follow up 35
G0410Grp psych partial hosp 45-50   
G0420Ed svc ckd ind per session G0420Ed svc ckd ind per session
G0421Ed svc ckd grp per session G0421Ed svc ckd grp per session
G0422Intens cardiac rehab w/exerc   
G0423Intens cardiac rehab no exer   
G0424Pulmonary rehab w exer   
G0425Inpt/ed teleconsult30 G0425Inpt/ed teleconsult30
G0426Inpt/ed teleconsult50 G0426Inpt/ed teleconsult50
G0427Inpt/ed teleconsult70 G0427Inpt/ed teleconsult70
   G0436Tobacco-use counsel 3-10 min
   G0437Tobacco-use counsel>10min
G0438Ppps, initial visit G0438Ppps, initial visit
G0439Ppps, subseq visit G0439Ppps, subseq visit
G0442Annual alcohol screen 15 min G0442Annual alcohol screen 15 min
G0443Brief alcohol misuse counsel G0443Brief alcohol misuse counsel
G0444Depression screen annual G0444Depression screen annual
G0445High inten beh couns std 30m G0445High inten beh couns std 30m
G0446Intens behave ther cardio dx G0446Intens behave ther cardio dx
G0447Behavior counsel obesity 15m G0447Behavior counsel obesity 15m
G0459Telehealth inpt pharm mgmt G0459Telehealth inpt pharm mgmt
G0506Comp asses care plan ccm svc G0506Comp asses care plan ccm svc
G0508Crit care telehea consult 60 G0508Crit care telehea consult 60
G0509Crit care telehea consult 50 G0509Crit care telehea consult 50
G0513Prolong prev svcs, first 30m G0513Prolong prev svcs, first 30m
G0514Prolong prev svcs, addl 30m G0514Prolong prev svcs, addl 30m
G2086Off base opioid tx 70min G2086Off base opioid tx first m
G2087Off base opioid tx, 60 m G2087Off base opioid tx, sub m
G2088Off base opioid tx, add30 G2088Off opioid tx month add 30
G2211Complex E/M visit add on
   
G2212Prolong outpt/office vis   
G9685Acute nursing facility care   


https://www.cms.gov/Medicare/Medicare-General-Information/Telehealth/Telehealth-Codes.html





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