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Understand Billing Guidelines for DrChat

Understand the billing guidelines for DrChat, including reimbursement eligibility and documentation requirements for compliant e-visits.

Introduction

This guide provides an overview of CPT® procedure codes for physician billing that may be used with DrChat products for online digital evaluation and management services (E-Visits). Please contact your local payer for interpretation of the appropriate codes to use for specific procedures.

Online Digital Evaluation and Management Services (E-Visits)

E-Visits are online digital evaluation and management services provided for an established patient over a cumulative period of up to 7 days.

E-Visit CPT® Codes for Physicians

For physicians providing online digital evaluation and management services:

  • 99421: 5-10 minutes

  • 99422: 11-20 minutes

  • 99423: 21 or more minutes

E-Visit CPT® Codes for Non-Physicians

For qualified non-physician healthcare professionals providing online digital assessment and management:

  • 98970: 5-10 minutes

  • 98971: 11-20 minutes

  • 98972: 21 or more minutes

Equivalent HCPCS codes: G2061, G2062, G2063

Virtual Check-In HCPCS Codes

For qualified non-physician healthcare professionals and physicians providing virtual check-in services:

  • G2010: Remote evaluation of recorded video and/or images submitted by an established patient, including interpretation with follow-up within 24 business hours. This must not originate from a related E/M service provided within the previous 7 days nor lead to an E/M service or procedure within the next 24 hours or soonest available appointment.

  • G2012: Brief communication technology-based service (e.g., virtual check-in) by a physician or other qualified healthcare professional. This must not originate from a related E/M service provided within the previous 7 days nor lead to an E/M service or procedure within the next 24 hours or soonest available appointment. Duration: 5-10 minutes of medical discussion.

Billing Best Practices

To ensure successful billing and reimbursement for digital services:

  • Verify patient eligibility with their insurance provider before conducting E-Visits.

  • Document all interactions thoroughly, including time spent and topics discussed.

  • Ensure that the services billed meet the medical necessity criteria of the payer.

  • Submit claims using the correct CPT® or HCPCS codes for the duration and nature of the service provided.

Disclaimer

DOCPACE provides this guide to assist in understanding the administrative and billing guidelines for online digital evaluation and management services and virtual check-in services. This guide does not guarantee reimbursement, billing approval, or insurance coverage. CMS Medicare Part B Physician Fee Schedule rates vary by geographic locality. Providers are responsible for determining accurate coding, coverage, claims submission guidelines, and clinical documentation requirements for services provided.

For additional information, contact drchat@docpace.com or visit DrChat.live.