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July 10, 2020

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AMA’s Telehealth Services Workgroup Convened for its Foundational Meeting to Discuss the Development of New Telemedicine Billing Codes

On October 8, 2015, the American Medical Association’s new Telehealth Services Workgroup met for the first time, as it began to consider ways to expand current telehealth service Current Procedural Terminology (CPT) Codes.  The AMA has recognized that the CPT code set must be updated to accurately reflect the telehealth services provided to patients, particularly as telehealth technology continues to advance and emerging telehealth services and remote patient monitoring becomes more important to the management of patient care. The Telehealth Services Workgroup is a committee consisting of experts representing physicians, health professionals, telemedicine innovators and health insurers.  The Workgroup is charged with four main objectives:

  1. Recommend solutions for the reporting of current non-telehealth services when using remote telehealth technology (to include but not be limited to Evaluation and Management, or E/M, services). Considerations will include potential new codes, use of current codes without or with modifier, add-on code(s).

  2. Address the accuracy of current code set in describing the services provided when telehealth data is reviewed and analyzed, including potential code set revisions and/or education for appropriate code use, potential code development to report an analysis of transmitted data, definition of data types, and potential new E/M services codes based on emerging new patterns for sites of service.

  3. Recommend whether any other telehealth service codes should be developed based upon services currently being provided.

  4. Develop new introductory language or modify existing introductory language to guide coding of telehealth services.

During its foundational meeting, the workgroup discussed the importance of the CPT code system, and it primarily intends to expand current telehealth CPT codes to include emerging services.  Moreover, CMS has added to the list of reimbursable telehealth visits to include annual visits, psychoanalysis, psychotherapy, and long-term evaluation and management services, all of which will need new codes.

The workgroup now intends to divide itself into subgroups and determine those areas most immediately in need of codes.  The group will make recommendations to the AMA’s CPT Editorial Panel, which creates and curates the codes for physicians billing services.

© 2020 Covington & Burling LLPNational Law Review, Volume V, Number 295


About this Author

Shruti Barker, Covington Burling, Healthcare attorney

Shruti Barker is an associate in the firm’s Washington, DC office, where she practices in the areas of health care, federal-state programs, and employee benefits. Ms. Barker advises state agencies, providers, food manufacturers, and other clients on issues related to government-sponsored health care programs. Ms. Barker has experience with an array of healthcare statutes and regulations, including Medicare, Medicaid, Women, Infants, and Children (“WIC”), and the Supplemental Nutrition Assistance Program.