1. Current Procedural Terminology (CPT) codes obtained through "Telehealth Services Covered by Medicare and Included in CPT Code Set tables".
2. Fee schedule sources include: Cahaba Government Benefit Administrators, CGS Administrators, LLC, First Coast Service Options, Inc., National Government Services, Inc., Noridian Administrative Services, LLC, Novitas Solutions, Inc., Palmetto GBA, Wisconsin Physician Service (WPS) Insurance Corporation.
3. The "initial visit" is defined as the first time a physician or practitioner provides a Medicare-covered Telehealth service to a patient.
4. A "subsequent visit" for telehealth is defined as a follow-up encounter with a patient for an established problem that is addressed during a previous visit. The CMS allows for the use of telehealth services for subsequent visits, as long as the services meet the requirements for coverage and payment
5. CPT code reimbursements are determined based on the most densely populated area within each state.
6. Our Medicare Calculator uses the 2023 reimbursement fees for CPT codes. For updated pricing on CPT codes, please click here.
7. For a comprehensive guide on CPT reimbursement codes, including their purposes and usage instructions, click here.