2022 Telehealth: 10 Important Billing Rules for CA Workers' Comp
As the COVID-19 pandemic drags on, telehealth remains a viable alternative to in-person treatment for California workers’ comp providers.
Below are the most important rules regarding telehealth services, as well as a complete list of all currently recognized telehealth billing codes.
Most telehealth reimbursements remain unchanged from 2021. However, a recent order from California’s Division of Workers’ Compensation (DWC) changes the status of several codes, specifically regarding the date some codes will cease to be applicable. Read on for details.
Make calculating 2022 OMFS reimbursements easy: Try our OMFS Calculator for accurate, instant, always-updated rates (Fee Schedules: California, New York and US DOL).
CA Workers’ Comp Telehealth: 10 Important Rules
Below are a few basic, crucial facts about telehealth in California workers’ comp:
1. Providers need to review their malpractice insurance. In some cases, existing policies may not be sufficient to protect your practice following the expansion of telehealth services. Review your policy, and make sure you’re covered for telehealth!
2. California workers’ comp rules for telehealth mirror CMS (Medicare) rules. In other words: any medical service that Medicare designates as permissible to deliver via telehealth is also permissible to deliver via telehealth in California workers’ comp.
3. Telehealth is not a type of medical treatment; telehealth is a means of delivering medical treatment. The use of telehealth to deliver medical services has no bearing on employer authorization or utilization review (UR). If the employer’s UR deems a given treatment medically necessary and appropriate, the treatment remains necessary and appropriate regardless of the delivery method.
4. For telehealth bills, the Place of Service (POS) that is reported on the bill reflects the place of service where the treatment would normally take place. A bill for medical treatment furnished via telehealth reports the same Place of Service as if the provider furnished the service in person, e.g., in an office, outpatient clinic, urgent care center, etc. — even if the provider treats from their living room.
5. Providers report procedure codes that reflect the treatment, regardless of whether treatment was delivered via telehealth. To bill for telehealth services, providers use the established CPT or HCPCS codes that identify a given treatment or service.
6. Modifier 95 identifies the service as delivered via telehealth. For telehealth bills, report the established CPT or HCPCS code that identifies the treatment or service, and add modifier - 95.
7. It is permissible to deliver certain medical services and treatments using audio-only technology, like the telephone. CMS defines telehealth as “using an interactive 2-way telecommunications system (like real-time audio and video).” However, Medicare designates the medical treatment and services (listed below) for which audio-only communication is a qualified method of telehealth delivery.
8. If Audio-only is not permissible, CMS requires a provider to furnish the telehealth using video-enabled technology. In most cases, the provider must utilize a live, real-time 2-way video connection with the patient (e.g. Skype) to compliantly deliver services via telehealth. Important: the video communication must not be public-facing, e.g. TikTok.
9. Reimbursement for telehealth services is the same as reimbursement for furnishing the services in person. Again, telehealth is a means of delivery, not a service. All medical services authorized by the employer are paid at the established OMFS rates, regardless of whether the services are delivered via telehealth.
10. The DWC alone determines California workers’ comp telehealth policy. Unfortunately, we’ve seen certain claims administrators attempt to bully providers into adhering to arbitrary telehealth requirements. Let’s be clear: while California chooses to take certain cues from CMS, no entity other than the DWC may dictate telehealth policy for California workers’ comp.
Telehealth Services List
The table below lists all the procedures (CPT/HCPCS) providers may deliver via telehealth for California workers’ comp. For each service, the table provides:
- Procedure code
- Brief service description
- Status as to how long the service may be delivered via telehealth: “Temporary Additions” have no established end date, while other services may be delivered via telehealth through the final year of the declared CMS Public Health Emergency. (Note that for some billing codes, CMS does not list any specific status.)
- Audio-only status: Providers may deliver services marked “Yes” via two-way, real-time audio-only technology, such as a landline telephone. Services marked “No” must be delivered via real-time, two-way video and audio connection.
Services Deliverable via Telehealth in CA Workers’ Compensation
Procedure Code |
Descriptor |
Status |
Audio-Only Permissible? |
0362T |
Bhv id suprt assmt ea 15 min |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 4/30/20 |
|
0373T |
Adapt bhv tx ea 15 min |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 4/30/20 |
|
77427 |
Radiation tx management x5 |
Temporary Addition for the PHE for the COVID-19 Pandemic |
|
90785 |
Psytx complex interactive |
Yes |
|
90791 |
Psych diagnostic evaluation |
Yes |
|
90792 |
Psych diag eval w/med srvcs |
Yes |
|
90832 |
Psytx w pt 30 minutes |
Yes |
|
90833 |
Psytx w pt w e/m 30 min |
Yes |
|
90834 |
Psytx w pt 45 minutes |
Yes |
|
90836 |
Psytx w pt w e/m 45 min |
Yes |
|
90837 |
Psytx w pt 60 minutes |
Yes |
|
90838 |
Psytx w pt w e/m 60 min |
Yes |
|
90839 |
Psytx crisis initial 60 min |
Yes |
|
90840 |
Psytx crisis ea addl 30 min |
Yes |
|
90845 |
Psychoanalysis |
Yes |
|
90846 |
Family psytx w/o pt 50 min |
Yes |
|
90847 |
Family psytx w/pt 50 min |
Yes |
|
90853 |
Group psychotherapy |
Yes |
|
90875 |
Psychophysiological therapy |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 4/30/20 |
|
90951 |
Esrd serv 4 visits p mo <2yr |
||
90952 |
Esrd serv 2-3 vsts p mo <2yr |
||
90953 |
Esrd serv 1 visit p mo <2yrs |
Available up Through December 31, 2023 |
|
90954 |
Esrd serv 4 vsts p mo 2-11 |
||
90955 |
Esrd srv 2-3 vsts p mo 2-11 |
||
90956 |
Esrd srv 1 visit p mo 2-11 |
Available up Through December 31, 2023 |
|
90957 |
Esrd srv 4 vsts p mo 12-19 |
||
90958 |
Esrd srv 2-3 vsts p mo 12-19 |
||
90959 |
Esrd serv 1 vst p mo 12-19 |
Available up Through December 31, 2023 |
|
90960 |
Esrd srv 4 visits p mo 20+ |
||
90961 |
Esrd srv 2-3 vsts p mo 20+ |
||
90962 |
Esrd serv 1 visit p mo 20+ |
Available up Through December 31, 2023 |
|
90963 |
Esrd home pt serv p mo <2yrs |
||
90964 |
Esrd home pt serv p mo 2-11 |
||
90965 |
Esrd home pt serv p mo 12-19 |
||
90966 |
Esrd home pt serv p mo 20+ |
||
90967 |
Esrd svc pr day pt <2 |
||
90968 |
Esrd svc pr day pt 2-11 |
||
90969 |
Esrd svc pr day pt 12-19 |
||
90970 |
Esrd svc pr day pt 20+ |
||
92002 |
Eye exam new patient |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 4/30/20 |
|
92004 |
Eye exam new patient |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 4/30/20 |
|
92012 |
Eye exam establish patient |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 4/30/20 |
|
92014 |
Eye exam&tx estab pt 1/>vst |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 4/30/20 |
|
92507 |
Speech/hearing therapy |
Available up Through December 31, 2023 |
Yes |
92508 |
Speech/hearing therapy |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 4/30/20 |
Yes |
92521 |
Evaluation of speech fluency |
Available up Through December 31, 2023 |
Yes |
92522 |
Evaluate speech production |
Available up Through December 31, 2023 |
Yes |
92523 |
Speech sound lang comprehen |
Available up Through December 31, 2023 |
Yes |
92524 |
Behavral qualit analys voice |
Available up Through December 31, 2023 |
Yes |
92526 |
Oral function therapy |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 3/30/21 |
|
92550 |
Tympanometry & reflex thresh |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 3/30/21 |
|
92552 |
Pure tone audiometry air |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 3/30/21 |
|
92553 |
Audiometry air & bone |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 3/30/21 |
|
92555 |
Speech threshold audiometry |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 3/30/21 |
|
92556 |
Speech audiometry complete |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 3/30/21 |
|
92557 |
Comprehensive hearing test |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 3/30/21 |
|
92563 |
Tone decay hearing test |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 3/30/21 |
|
92565 |
Stenger test pure tone |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 3/30/21 |
|
92567 |
Tympanometry |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 3/30/21 |
|
92568 |
Acoustic refl threshold tst |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 3/30/21 |
|
92570 |
Acoustic immitance testing |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 3/30/21 |
|
92587 |
Evoked auditory test limited |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 3/30/21 |
|
92588 |
Evoked auditory tst complete |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 5/10/21 |
|
92601 |
Cochlear implt f/up exam <7 |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 4/30/20 |
|
92602 |
Reprogram cochlear implt <7 |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 4/30/20 |
|
92603 |
Cochlear implt f/up exam 7/> |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 4/30/20 |
|
92604 |
Reprogram cochlear implt 7/> |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 4/30/20 |
|
92607 |
Ex for speech device rx 1hr |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 3/30/21 |
|
92608 |
Ex for speech device rx addl |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 3/30/21 |
|
92609 |
Use of speech device service |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 3/30/21 |
|
92610 |
Evaluate swallowing function |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 3/30/21 |
|
92625 |
Tinnitus assessment |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 3/30/21 |
|
92626 |
Eval aud funcj 1st hour |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 3/30/21 |
|
92627 |
Eval aud funcj ea addl 15 |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 3/30/21 |
|
93750 |
Interrogation vad in person |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 10/14/20 |
|
93797 |
Cardiac rehab |
Available up Through December 31, 2023 |
|
93798 |
Cardiac rehab/monitor |
Available up Through December 31, 2023 |
|
94002 |
Vent mgmt inpat init day |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 4/30/20 |
|
94003 |
Vent mgmt inpat subq day |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 4/30/20 |
|
94004 |
Vent mgmt nf per day |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 4/30/20 |
|
94005 |
Home vent mgmt supervision |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 4/30/20 |
|
94664 |
Evaluate pt use of inhaler |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 4/30/20 |
|
95970 |
Alys npgt w/o prgrmg |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 10/14/20 |
|
95971 |
Alys smpl sp/pn npgt w/prgrm |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 10/14/20 |
|
95972 |
Alys cplx sp/pn npgt w/prgrm |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 10/14/20 |
|
95983 |
Alys brn npgt prgrmg 15 min |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 10/14/20 |
|
95984 |
Alys brn npgt prgrmg addl 15 |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 10/14/20 |
|
96105 |
Assessment of aphasia |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 3/30/21 |
|
96110 |
Developmental screen w/score |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 4/30/20 |
|
96112 |
Devel tst phys/qhp 1st hr |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 4/30/20 |
|
96113 |
Devel tst phys/qhp ea addl |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 4/30/20 |
|
96116 |
Nubhvl xm phys/qhp 1st hr |
Yes |
|
96121 |
Nubhvl xm phy/qhp ea addl hr |
Yes |
|
96125 |
Cognitive test by hc pro |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 3/30/21 |
|
96127 |
Brief emotional/behav assmt |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 4/30/20 |
Yes |
96130 |
Psycl tst eval phys/qhp 1st |
Available up Through December 31, 2023 |
Yes |
96131 |
Psycl tst eval phys/qhp ea |
Available up Through December 31, 2023 |
Yes |
96132 |
Nrpsyc tst eval phys/qhp 1st |
Available up Through December 31, 2023 |
Yes |
96133 |
Nrpsyc tst eval phys/qhp ea |
Available up Through December 31, 2023 |
Yes |
96136 |
Psycl/nrpsyc tst phy/qhp 1st |
Available up Through December 31, 2023 |
Yes |
96137 |
Psycl/nrpsyc tst phy/qhp ea |
Available up Through December 31, 2023 |
Yes |
96138 |
Psycl/nrpsyc tech 1st |
Available up Through December 31, 2023 |
Yes |
96139 |
Psycl/nrpsyc tst tech ea |
Available up Through December 31, 2023 |
Yes |
96156 |
Hlth bhv assmt/reassessment |
Yes |
|
96158 |
Hlth bhv ivntj indiv 1st 30 |
Yes |
|
96159 |
Hlth bhv ivntj indiv ea addl |
Yes |
|
96160 |
Pt-focused hlth risk assmt |
Yes |
|
96161 |
Caregiver health risk assmt |
Yes |
|
96164 |
Hlth bhv ivntj grp 1st 30 |
Yes |
|
96165 |
Hlth bhv ivntj grp ea addl |
Yes |
|
96167 |
Hlth bhv ivntj fam 1st 30 |
Yes |
|
96168 |
Hlth bhv ivntj fam ea addl |
Yes |
|
96170 |
Hlth bhv ivntj fam wo pt 1st |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 4/30/20 |
|
96171 |
Hlth bhv ivntj fam w/o pt ea |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 4/30/20 |
|
97110 |
Therapeutic exercises |
Available up Through December 31, 2023 |
|
97112 |
Neuromuscular reeducation |
Available up Through December 31, 2023 |
|
97116 |
Gait training therapy |
Available up Through December 31, 2023 |
|
97129 |
Ther ivntj 1st 15 min |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 3/30/21 |
|
97130 |
Ther ivntj ea addl 15 min |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 3/30/21 |
|
97150 |
Group therapeutic procedures |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 4/30/20 |
|
97151 |
Bhv id assmt by phys/qhp |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 4/30/20 |
|
97152 |
Bhv id suprt assmt by 1 tech |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 4/30/20 |
|
97153 |
Adaptive behavior tx by tech |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 4/30/20 |
|
97154 |
Grp adapt bhv tx by tech |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 4/30/20 |
|
97155 |
Adapt behavior tx phys/qhp |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 4/30/20 |
|
97156 |
Fam adapt bhv tx gdn phy/qhp |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 4/30/20 |
|
97157 |
Mult fam adapt bhv tx gdn |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 4/30/20 |
|
97158 |
Grp adapt bhv tx by phy/qhp |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 4/30/20 |
|
97161 |
Pt eval low complex 20 min |
Available up Through December 31, 2023 |
|
97162 |
Pt eval mod complex 30 min |
Available up Through December 31, 2023 |
|
97163 |
Pt eval high complex 45 min |
Available up Through December 31, 2023 |
|
97164 |
Pt re-eval est plan care |
Available up Through December 31, 2023 |
|
97165 |
Ot eval low complex 30 min |
Available up Through December 31, 2023 |
|
97166 |
Ot eval mod complex 45 min |
Available up Through December 31, 2023 |
|
97167 |
Ot eval high complex 60 min |
Available up Through December 31, 2023 |
|
97168 |
Ot re-eval est plan care |
Available up Through December 31, 2023 |
|
97530 |
Therapeutic activities |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 4/30/20 |
|
97535 |
Self care mngment training |
Available up Through December 31, 2023 |
Yes |
97542 |
Wheelchair mngment training |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 4/30/20 |
|
97750 |
Physical performance test |
Available up Through December 31, 2023 |
|
97755 |
Assistive technology assess |
Available up Through December 31, 2023 |
|
97760 |
Orthotic mgmt&traing 1st enc |
Available up Through December 31, 2023 |
|
97761 |
Prosthetic traing 1st enc |
Available up Through December 31, 2023 |
|
97802 |
Medical nutrition indiv in |
Yes |
|
97803 |
Med nutrition indiv subseq |
Yes |
|
97804 |
Medical nutrition group |
Yes |
|
99202 |
Office/outpatient visit new |
||
99203 |
Office/outpatient visit new |
||
99204 |
Office/outpatient visit new |
||
99205 |
Office/outpatient visit new |
||
99211 |
Office/outpatient visit est |
||
99212 |
Office/outpatient visit est |
||
99213 |
Office/outpatient visit est |
||
99214 |
Office/outpatient visit est |
||
99215 |
Office/outpatient visit est |
||
99217 |
Observation care discharge |
Available up Through December 31, 2023 |
|
99218 |
Initial observation care |
Temporary Addition for the PHE for the COVID-19 Pandemic |
|
99219 |
Initial observation care |
Temporary Addition for the PHE for the COVID-19 Pandemic |
|
99220 |
Initial observation care |
Temporary Addition for the PHE for the COVID-19 Pandemic |
|
99221 |
Initial hospital care |
Temporary Addition for the PHE for the COVID-19 Pandemic |
|
99222 |
Initial hospital care |
Temporary Addition for the PHE for the COVID-19 Pandemic |
|
99223 |
Initial hospital care |
Temporary Addition for the PHE for the COVID-19 Pandemic |
|
99224 |
Subsequent observation care |
Available up Through December 31, 2023 |
|
99225 |
Subsequent observation care |
Available up Through December 31, 2023 |
|
99226 |
Subsequent observation care |
Available up Through December 31, 2023 |
|
99231 |
Subsequent hospital care |
||
99232 |
Subsequent hospital care |
||
99233 |
Subsequent hospital care |
||
99234 |
Observ/hosp same date |
Temporary Addition for the PHE for the COVID-19 Pandemic |
|
99235 |
Observ/hosp same date |
Temporary Addition for the PHE for the COVID-19 Pandemic |
|
99236 |
Observ/hosp same date |
Temporary Addition for the PHE for the COVID-19 Pandemic |
|
99238 |
Hospital discharge day |
Available up Through December 31, 2023 |
|
99239 |
Hospital discharge day |
Available up Through December 31, 2023 |
|
99281 |
Emergency dept visit |
Available up Through December 31, 2023 |
|
99282 |
Emergency dept visit |
Available up Through December 31, 2023 |
|
99283 |
Emergency dept visit |
Available up Through December 31, 2023 |
|
99284 |
Emergency dept visit |
Available up Through December 31, 2023 |
|
99285 |
Emergency dept visit |
Available up Through December 31, 2023 |
|
99291 |
Critical care first hour |
Available up Through December 31, 2023 |
|
99292 |
Critical care addl 30 min |
Available up Through December 31, 2023 |
|
99304 |
Nursing facility care init |
Temporary Addition for the PHE for the COVID-19 Pandemic |
|
99305 |
Nursing facility care init |
Temporary Addition for the PHE for the COVID-19 Pandemic |
|
99306 |
Nursing facility care init |
Temporary Addition for the PHE for the COVID-19 Pandemic |
|
99307 |
Nursing fac care subseq |
||
99308 |
Nursing fac care subseq |
||
99309 |
Nursing fac care subseq |
||
99310 |
Nursing fac care subseq |
||
99315 |
Nursing fac discharge day |
Available up Through December 31, 2023 |
|
99316 |
Nursing fac discharge day |
Available up Through December 31, 2023 |
|
99324 |
Domicil/r-home visit new pat |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 4/30/20 |
|
99325 |
Domicil/r-home visit new pat |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 4/30/20 |
|
99326 |
Domicil/r-home visit new pat |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 4/30/20 |
|
99327 |
Domicil/r-home visit new pat |
Temporary Addition for the PHE for the COVID-19 Pandemic |
|
99328 |
Domicil/r-home visit new pat |
Temporary Addition for the PHE for the COVID-19 Pandemic |
|
99334 |
Domicil/r-home visit est pat |
||
99335 |
Domicil/r-home visit est pat |
||
99336 |
Domicil/r-home visit est pat |
Available up Through December 31, 2023 |
|
99337 |
Domicil/r-home visit est pat |
Available up Through December 31, 2023 |
|
99341 |
Home visit new patient |
Temporary Addition for the PHE for the COVID-19 Pandemic |
|
99342 |
Home visit new patient |
Temporary Addition for the PHE for the COVID-19 Pandemic |
|
99343 |
Home visit new patient |
Temporary Addition for the PHE for the COVID-19 Pandemic |
|
99344 |
Home visit new patient |
Temporary Addition for the PHE for the COVID-19 Pandemic |
|
99345 |
Home visit new patient |
Temporary Addition for the PHE for the COVID-19 Pandemic |
|
99347 |
Home visit est patient |
||
99348 |
Home visit est patient |
||
99349 |
Home visit est patient |
Available up Through December 31, 2023 |
|
99350 |
Home visit est patient |
Available up Through December 31, 2023 |
|
99354 |
Prolong e&m/psyctx serv o/p |
Yes |
|
99355 |
Prolong e&m/psyctx serv o/p |
Yes |
|
99356 |
Prolonged service inpatient |
Yes |
|
99357 |
Prolonged service inpatient |
Yes |
|
99406 |
Behav chng smoking 3-10 min |
Yes |
|
99407 |
Behav chng smoking > 10 min |
Yes |
|
99441 |
Phone e/m phys/qhp 5-10 min |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 4/30/20 |
Yes |
99442 |
Phone e/m phys/qhp 11-20 min |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 4/30/20 |
Yes |
99443 |
Phone e/m phys/qhp 21-30 min |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 4/30/20 |
Yes |
99468 |
Neonate crit care initial |
Temporary Addition for the PHE for the COVID-19 Pandemic |
|
99469 |
Neonate crit care subsq |
Available up Through December 31, 2023 |
|
99471 |
Ped critical care initial |
Temporary Addition for the PHE for the COVID-19 Pandemic |
|
99472 |
Ped critical care subsq |
Available up Through December 31, 2023 |
|
99473 |
Self-meas bp pt educaj/train |
Temporary Addition for the PHE for the COVID-19 Pandemic |
|
99475 |
Ped crit care age 2-5 init |
Temporary Addition for the PHE for the COVID-19 Pandemic |
|
99476 |
Ped crit care age 2-5 subsq |
Available up Through December 31, 2023 |
|
99477 |
Init day hosp neonate care |
Temporary Addition for the PHE for the COVID-19 Pandemic |
|
99478 |
Ic lbw inf < 1500 gm subsq |
Available up Through December 31, 2023 |
|
99479 |
Ic lbw inf 1500-2500 g subsq |
Available up Through December 31, 2023 |
|
99480 |
Ic inf pbw 2501-5000 g subsq |
Available up Through December 31, 2023 |
|
99483 |
Assmt & care pln pt cog imp |
||
99495 |
Trans care mgmt 14 day disch |
||
99496 |
Trans care mgmt 7 day disch |
||
99497 |
Advncd care plan 30 min |
Yes |
|
99498 |
Advncd care plan addl 30 min |
Yes |
|
G0108 |
Diab manage trn per indiv |
Yes |
|
G0109 |
Diab manage trn ind/group |
Yes |
|
G0270 |
Mnt subs tx for change dx |
Yes |
|
G0296 |
Visit to determ ldct elig |
Yes |
|
G0396 |
Alcohol/subs interv 15-30mn |
Yes |
|
G0397 |
Alcohol/subs interv >30 min |
Yes |
|
G0406 |
Inpt/tele follow up 15 |
Yes |
|
G0407 |
Inpt/tele follow up 25 |
Yes |
|
G0408 |
Inpt/tele follow up 35 |
Yes |
|
G0410 |
Grp psych partial hosp 45-50 |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 4/30/20 |
|
G0420 |
Ed svc ckd ind per session |
Yes |
|
G0421 |
Ed svc ckd grp per session |
Yes |
|
G0422 |
Intens cardiac rehab w/exerc |
Available up Through December 31, 2023 |
|
G0423 |
Intens cardiac rehab no exer |
Available up Through December 31, 2023 |
|
G0424 |
Pulmonary rehab w exer |
Available up Through December 31, 2023 |
|
G0425 |
Inpt/ed teleconsult30 |
Yes |
|
G0426 |
Inpt/ed teleconsult50 |
Yes |
|
G0427 |
Inpt/ed teleconsult70 |
Yes |
|
G0438 |
Ppps, initial visit |
Yes |
|
G0439 |
Ppps, subseq visit |
Yes |
|
G0442 |
Annual alcohol screen 15 min |
Yes |
|
G0443 |
Brief alcohol misuse counsel |
Yes |
|
G0444 |
Depression screen annual |
Yes |
|
G0445 |
High inten beh couns std 30m |
Yes |
|
G0446 |
Intens behave ther cardio dx |
Yes |
|
G0447 |
Behavior counsel obesity 15m |
Yes |
|
G0459 |
Telehealth inpt pharm mgmt |
Yes |
|
G0506 |
Comp asses care plan ccm svc |
Yes |
|
G0508 |
Crit care telehea consult 60 |
||
G0509 |
Crit care telehea consult 50 |
||
G0513 |
Prolong prev svcs, first 30m |
Yes |
|
G0514 |
Prolong prev svcs, addl 30m |
Yes |
|
G2086 |
Off base opioid tx 70min |
Yes |
|
G2087 |
Off base opioid tx, 60 m |
Yes |
|
G2088 |
Off base opioid tx, add30 |
Yes |
|
G2211 |
Complex E/M visit add on |
Yes |
|
G2212 |
Prolong outpt/office vis |
Yes |
|
G9685 |
Acute nursing facility care |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 4/30/20 |
|
S9152 |
Speech therapy, re-eval |
Temporary Addition for the PHE for the COVID-19 Pandemic—Added 4/30/20 |
Feel free to watch the replay of our most recent webinar on telehealth in California workers’ comp..
We obsess over OMFS — so you don’t have to. Try the DaisyWizard, a billing tool that includes our OMFS Calculator for instant, accurate reimbursement rates.
TRY DAISYWIZARD FREE
DaisyBill provides content as an insightful service to its readers and clients. It does not offer legal advice and cannot guarantee the accuracy or suitability of its content for a particular purpose.
.gif)
