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Today's podiatrist has the necessary education and training to treat all conditions of the foot and ankle and plays a key role in keeping America healthy and mobile while helping combat diabetes and other chronic diseases.
Your feet are excellent barometers for your overall health. Healthy feet keep you moving and active. They are quite literally your foundation. In this section, learn more about APMA Seal-approved and accepted products, proper foot care, common foot and ankle conditions, and how your podiatrist can help keep you and your feet healthy.
APMA is the only organization lobbying for podiatrists and their patients on Capitol Hill. As the voice of podiatric medicine to your legislators and regulators, APMA is active on a variety of critical issues affecting podiatry and the entire health-care system.
Through the end of 2024, there are four main non-face-to-face service types podiatrists can provide. A podiatrist’s ability to employ these services and be reimbursed for these services may differ based on the patient’s insurance and state licensure. Always check with payer and state licensure guidelines before providing any service.
The four main non-face-to-face service options include:
1. Telehealth services that are normally furnished in person which are instead furnished remotely using interactive, real-time telecommunication technology
Through the end of 2024, CMS and some other payers are allowing certain services to be provided via telehealth with the provider in any location and the patient in any location.
For Medicare beneficiaries, providers can use this option for office or other outpatient evaluation and management (E&M) services (CPT® 99202–99215) and all services listed here
Must use a communication tool that allows live, real-time interactive audio and video communication
Providers are permitted to reduce or waive cost-sharing for these services if they wish
Append modifier 95
Use the Place of Service that would have been used had the service been rendered in person (e.g., POS 11 for CPT 99213 and POS 32 for CPT 99307)
These services will be paid at the regular, in-person rate by CMS through the end of 2024
This waiver is in place through the end of 2024
Postoperative global periods apply
Does not need to be patient initiated
Document a progress note as if this service was provided face-to-face. This interaction is an E&M service and E&M documentation requirements apply.
2. Medicare virtual check-in
G2012: Brief communication technology-based service (e.g., virtual check-in) by a physician or other qualified health-care professional who can report evaluation and management services, provided to an established patient, not originating from a related E/M service provided within the previous seven days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment; 5–10 minutes of medical discussion
G2252 - Brief communication technology-based service, eg, virtual check-in, by a physician or other qualified health-care professional who can report evaluation and management services, provided to an established patient, not originating from a related E/M service provided within the previous seven days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment; 11-20 minutes of medical discussion
Payable by Medicare Part B and Medicare Advantage
Can be any type of telecommunication tool, including telephone
CANNOT relate to any service in the last seven days
CANNOT result in patient coming in within the next 24 hours or soonest available appointment
Must be patient initiated
No telemedicine-related modifiers needed
Providers are permitted to reduce or waive patient cost-sharing for these services if they wish
3. Telephone E/M services
This interaction is an E/M service and documentation must support an E/M just like any other E/M type. Must have history, as much of an evaluation as possible, and some form of medical management.
Must be initiated by patient or the patient’s guardian
Payable by Medicare and some non-Medicare payers during the PHE
CANNOT report if call results in decision to see patient within 24 hours or next available urgent appointment
CANNOT report if call refers to E/M service performed by same provider within previous seven days
CANNOT report if call refers to a problem for which a patient is in a global period
CANNOT report if provider performed a telephone E/M or online digital E/M for the same patient for the same problem in the last seven days
CANNOT report if the call is part of Home Care Oversight Services, Care Plan Oversight Services, Home/Outpatient INR Monitoring, Complex Care Management Services, or Transitional Care Management Services
CPT 99441 - Telephone evaluation and management service by a physician or other qualified health-care professional who may report evaluation and management services provided to an established patient, parent, or guardian not originating from a related E/M service provided within the previous seven days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment; 5–10 minutes of medical discussion
CPT 99442– ; 11–20 minutes of medical discussion
CPT 99443– ; 21–30 minutes of medical discussion
4. Online digital E/M services
This interaction is an E/M service and documentation must support an E/M just like any other E/M type. Must have history, as much of an evaluation as possible, and some form of medical management.
Examples of digital platforms:
Electronic health record
Email
Text message
Other two-way digital communication
Must be initiated by patient via a digital platform
Payable by Medicare through the end of 2024
Providers are permitted to reduce or waive patient cost-sharing for these services if they wish
CANNOT report if service refers to a problem for which a patient is in a global period
CANNOT report if service is initiated within seven days of any E/M for same problem
CANNOT report if performed on same day as in-person E/M service
CANNOT report if service is part of Home Care Oversight Services, Care Plan Oversight Services, Home/Outpatient INR Monitoring, Complex Care Management Services, or Transitional Care Management Services
Time spent is cumulative time over seven days starting with review of the request
Can only report once per seven-day period
Time includes:
Review of inquiry
Review of patient records
Interaction with other staff
Development of management plan
Rx
Ordering tests
Communication with patient
Add time if multiple providers in same practice perform this service for the same patient over the same seven-day period
If within seven days of the initiation of an online digital E/M service, a separately reported E/M visit occurs, then the provider work devoted to the online digital E/M service is incorporated into the separately reported E/M visit
CPT 99421: Online digital evaluation and management service, for an established patient, for up to seven days, cumulative time during the seven days; 5–10 minutes
CPT 99422 ; 11–20 minutes
CPT 99423 ; 21 or more minutes
APMA suggests obtaining informed consent for these services. APMA further suggests that members advise patients that there will be a charge for these services, that copays and deductibles may apply, and referrals may be necessary if required by the insurance plan.
References:
HHS Notification of Enforcement Discretion for Telehealth Remote Communications During the COVID-19 Nationwide Public Health Emergency - https://www.hhs.gov/hipaa/for-professionals/special-topics/emergency-preparedness/notification-enforcement-discretion-telehealth/index.html
Current Procedural Terminology (CPT®) is copyright 1966, 1970, 1973, 1977, 1981, 1983–2020 by the American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association (AMA). Reference: 2020 CPT Professional
CPT codes and their descriptions do not reflect or guarantee coverage or payment. The existence of a CPT / HCPCS code does not guarantee payment for the service it describes. Coverage and payment policies of governmental and private payers vary from time to time and for different areas of the country. Questions regarding coverage and payment by a payer should be directed to that payer. APMA and its employees, consultants, and officers do not claim responsibility for any consequences or liability attributable to the use of any information, guidance, or advice contained in this communication or liability attributable to the use of any information, guidance, or advice contained in this communication.
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