E-Visits – What you need to know!

E-Visits aren’t new. You’ve been interacting with patients through your online portals for years. Getting paid for them, is. Here’s what you need to know to make sure you are meeting the requirements needed to support your E-Visit.

What is an E-Visit?

CMS defines e-visits as communication between an established patient (18+ years old) with their provider through an online portal, like MyChart.

What are the codes used to report E-Visits?

CPT offers two code sets. The first code set is for those providers who are recognized to report E/M (Evaluation and Management) Services (Physicians and OQHP (Other Qualified Healthcare Professionals). The second, for those non-physician clinicians that are licensed to perform other services (Qualified Non-Physician Healthcare Professionals).

Physicians and OQHP (NP/PA/CNS)

E-Visit Codes

Qualified Non-Physician Professionals (e.g. PTs, OTs, SLPs, licensed CPs, CSWs, and RDs)

Online Digital Assessment Codes

Use POS (Place of Service) code equal to what it would have been had the service been furnished in-person.

What are the requirements?

• The patient must be an established patient, 18+ years old, who has given consent for e-visit (co-pays apply)
• The e-visit must have been initiated by the patient
• The e-visit must not result in an in-person (includes A/V Telemedicine) visit within a 7-day period (for same condition that prompted e-visit) and not in a global period for same/similar condition
• Minimum time for lowest level is 5″ cumulative time over a 7-day period (do not report service for less than 5″)

If you would like for our team to have a discussion regarding e-visits at one of your faculty meetings, please contact [email protected], [email protected], or, see our Meet the Team page for your compliance liaison.

For more information and documentation tips, please see our tip sheet linked below.

Resources:

MSHBC E-Visit Tip Sheet