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CPT Code 0074T allows Healthcare Consults Online.

CPT code for online consultation- A revolution in healthcare delivery?

 

(See important Editor's update below)

 

Summary of presentation given by OnlineClinics' President, Dr. Ron Kraus, at the AATP 2004 meeting in NYC during the American Psychiatric Association's annual convention.

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Early in 2004, the American Medical Association has published a new CPT code 0074T that allows physicians in the USA reimbursement for online consults. The new code was released January 1st, 2004 and is in effect since July 1st, 2004. 

Code 0074T: Online evaluation & management service, per encounter, provided by a physician, using the Internet or similar electronic communications network, in response to a patientís request, established patient.


*  Online Medical Evaluation
An online medical evaluation is a type of Evaluation & Management service provided by a physician or qualified health care professional, to a patient using Internet resources, in response to the patientís online inquiry.  Reportable services involve the physicianís personal timely response to the patientís inquiry and must involve permanent storage (electronic or hard copy) of the encounter.  This service should not be reported for patient contacts (e.g., telephone calls) considered to be pre-service or post-service work for other E&M or non E&M services.  A reportable service would encompass the sum of communication (e.g., related telephone calls, prescription provision, laboratory orders) pertaining to the online patient encounter or problem(s).

The above is good news for those who work to bring healthcare online, as it means that online consultation is now recognized as a billable, acceptable service modality that can be practiced by healthcare professionals. As the new code takes effect, clinicians will be allowed to counsel existing patients using electronic communications means and then charge the healthcare insurance company for the time/service(s) provided. 

 

The existence of the code for physicians in the USA does not necessarily imply that ALL health insurance carriers in the market will immediately adopt or accept it. Clinicians and patients are advised to check with their insurance company to see if the above is, indeed, already among their recognized codes.

 

(*) As taken from AMA (01/2004 New code released):: http://www.ama-assn.org/ama/pub/article/3885-4897.html

 

Editorís update:

CPT code 0074T was replaced in 2008. The code relating to online counseling was previously in the CPT manual under category III (emerging technologies).  As of 2008, it has been replaced by the new code numbers and is now under category I.

CPT Code 98969 is used to describe online services provided by non physician. CPT code 98966 is used to bill for phone consultation services.

See:

http://www.todayshospitalist.com/index.php?b=articles_read&cnt=498

http://www.acpinternist.org/archives/2008/01/billing.htm

http://www.memo-snap.com/memo-snap/cpt.htm

http://www.aafp.org/online/en/home/publications/news/news-now/practice-management/20080229cptcodes.html

 

http://www.google.com/#hl=en&source=hp&q=CPT+Code

 

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