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by Steven White
Audiologists and speech-language pathologists have three additional codes for reporting services provided over the telephone in 2008.
The new Current Procedural Terminology (CPT, © American Medical Association) include codes for "non-face-to-face assessment and management services provided by a qualified health care professional to a patient using the telephone. These codes are used to report episodes of care by the qualified health care professional initiated by an established patient or guardian of an established patient."
Certain conditions preclude the use of the codes; they cannot be used if the patient is seen within 24 hours of the phone call or during the next available urgent visit appointment, or if the patient was seen within the previous seven days.
Medicare will not reimburse for the new telephone services codes. According to the Centers for Medicare and Medicaid Services (CMS), "(1) These services are non-face-to-face; and (2) the code descriptor includes language that recognizes the provision of services to parties other than the beneficiary and for whom Medicare does not provide coverage (for example, guardian)." Other health plans are not bound by the CMS decision and may elect to cover the codes. At least one private health plan, Blue Cross and Blue Shield of North Carolina, included the codes in its medical policy update.
The new codes are:
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98966: Telephone assessment and management service provided by a qualified nonphysician health care professional to an established patient, parent, or guardian not originating from a related assessment and management service provided within the previous seven days nor leading to an assessment and management service or procedure with the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion
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98967: 11-20 minutes of medical discussion
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98968: 21-30 minutes of medical discussion
Contact reimbursement@asha.org with questions or comments about the new telephone services codes.
Steven White, director of health care economics and advocacy, can be reached at swhite@asha.org.
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