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Telemedicine, time billing for counseling

Luz Posted Fri 10th of April, 2020 15:34:28 PM
Telemedicine billing for an outpatient followup visit level 5 based on time, do all 40 minutes need to be face-to-face? There was a question that one would only need more than 50% (25 minutes) face-to-face in counseling and coordination of care to qualify for a followup visit level 5. Thank you
SuperCoder Answered Mon 13th of April, 2020 10:56:29 AM

Hello Luz,

Thank you for your question.


In order to qualify for level 5, typically, 40 minutes are spent face-to-face with the patient and/or family.


The provider must include a record of total time of the visit as well as the time spent in the specific counseling or coordination of care activities.


You can use time as the controlling factor to report an outpatient follow-up visit if more than 50% of the total visit time is comprised of counseling and coordination of care.


Example: If your total visit time is 40 minutes, and more than 50% of 40 minutes of the total time, is spent on coordination of care, level 5 code can be reported.

Now, if in your documentation, the total time is 40 minutes and 25 minutes were spent on coordination of care, then you have qualified for level 5 E/M visit.


Hope that helps!


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