March 12, 2025
Effective Jan. 1, 2025, Clinical Payment and Coding Policy CPCP033, Telemedicine and Telehealth/Virtual Health Care Services, has been revised with new coding guidance in accordance with the American Medical Association.
The AMA established new evaluation and management telemedicine services codes effective Jan. 1, 2025. These services are similar to office/outpatient visits except they require a communication-based technology.
Unless otherwise noted in the code descriptor, the new telemedicine services codes are based on the level of medical decision making, or the total time for the evaluation and management service rendered on the date of the encounter.
For more details, refer to the revised policy.
The information provided does not constitute coding or legal advice. Physicians and other health care providers should use their own medical judgment based upon all available information and the condition of the patient in determining the appropriate course of treatment, and to submit claims using the most appropriate code(s) based upon the medical record documentation, coding guidelines and reference materials.