Medicare’s virtual check-in codes
AOA Coding Experts Doug Morrow, O.D., Harvey Richman, O.D., Rebecca Wartman, O.D.
The AOA has long supported appropriate use of telehealth services that rely on an established doctor-patient relationship. For 2019, the Centers for Medicare & Medicaid Services (CMS) established a policy to pay separately for two new physicians' services that are provided with the use of communication technology:
HCPCS code G2012: Brief communication technology-based service (e.g., virtual check-in)
HCPCS code G2010: Remote evaluation of recorded video and/or images submitted by an established patient
Doctors of optometry can now be paid separately for G2012 when a patient checks in with the doctor by phone or through another telecommunications device to decide if an in-person office visit, or if different patient care, may be necessary. CMS believes that this new service can help to increase efficiency.
For more information regarding the requirements for billing these services, review the 2019 Final Rule, pages 59483 to 59489.
G2010 is intended to be reported when a doctor reviews recorded video and/or images submitted by an established patient. Doctors of optometry and other physicians can now be reimbursed for reviewing patient-transmitted photo or video information conducted via pre-recorded "store and forward" video or image technology. Again, the use of this technology and the physician's review is intended to determine whether an in-person visit is needed.
Reimbursement for these services varies by geographic location. For G2012 the range of reimbursement is approximately $12 to $18, while for G2010 reimbursement is approximately $8 to $16. To find reimbursement in your area, access the Medicare fee schedule look up.
AOA member resources for coding
AOA Coding Today is an online, comprehensive database that contains information in real time for CPT, ICD-10 and HCPCS coding and research. The website is tailored specifically to optometry, assists doctors and staff in correct reimbursement and compliance, and has an easy-to-use code diagnosis ability based on region.
Complete the online form for direct access to coding experts for answers to your coding questions.
Purchase coding resources from the AOA Marketplace.
Ask the coding experts
If you have any questions regarding Medical Records and Coding, please submit them by using the Coding Experts Submission Form and one of our coding experts will be in contact with you.
Most asked coding questions: dilation
The AOA’s experts provide answers to the questions your colleagues are asking.
COVID-19 PHE ending: What does that mean for telemedicine?
The public health emergency officially expires on May 11 with immediate consequences on PREP Act vaccination authority and federal student loans, while telehealth allowances receive several months’ reprieve.
2 points to keep in mind when patients decline dilation
While dilation is not required when coding for a comprehensive eye exam following CPT guidance, it is the standard of care.