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Attention providers:
Telemedicine Policy Billing Guide Updates
On November 1, 2024, HCA notified providers of an update to the Store and Forward section in HCA’s Telemedicine Policy Billing Guide effective for dates of service on and after January 1, 2025. HCA published these changes early to assist providers during the transition of these policies. Since then, HCA became aware of several necessary updates to the guide. The changes include all the following:
- Added requirements for practitioners billing services provided via telemedicine to a client located in Washington State, including information on interstate compacts licensure
- Added requirements for the service(s) being rendered including that the service(s) must be clinically appropriate to be provided via telemedicine for that client, on the date of service
- Removed CPT® codes 99441, 99442, and 99443 from the table in the What evaluation and management services may be provided via telephone or patient portal? section
- Replaced HCPCS code G2012 with CPT® code 98016 in the What non-evaluation and management services may be provided via a virtual check-in?
Apple Health (Medicaid) Physical Health Audio-Only Procedure Code List Updates
Effective for dates on and after January 1, 2025, HCA made numerous changes to the Apple Health (Medicaid) Physical Health Audio-Only Procedure Code List including all the following:
- Added CPT® codes 59610 and 59618 and HCPCS codes G0136, H0004, and H0050
- Removed CPT® codes 99441, 99442, and 99443.
For a complete list of changes, consult the Change Log at the end of the list.
HCA revised the Telemedicine Policy and Billing Guide and the Apple Health (Medicaid) Physical Health Audio-Only Procedure Code List with these changes, and the revised guide and list may be viewed and downloaded from HCA’s Provider billing guides and fee schedules webpage.
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