As of January 1, 2019, Medicare will pay separately for a newly defined type of physicians' service termed as, “Brief communication technology-based service, e.g. virtual check-in…" The HCPCs code is G2012 and is defined as,

“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 7 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."

HCPC G2012 FACTS:

• Communication must be directly between PATIENT AND BILLING PRACTITIONERs (MD, DO or NP, PA, CNS depending on the scope of practice, licensing, etc.)
• Communication must be with an ESTABLISHED patient
• Communication must be directly between PATIENT AND BILLING PRACTITIONERs (MD, DO or NP, PA, CNS depending on the scope of practice, licensing, etc.)
•  Communication must be with an ESTABLISHED patient  
  • CPT defines established patient as "as one who has received professional services from the physician or qualified health care professional or another physician or qualified health care professional of the exact same specialty and subspecialty who belongs to the same group practice, within the past 3 years."
• Communication assess whether an in-person office visit is needed  
• Verbal consent must be obtained from patient EACH time a virtual check in is performed    
• The verbal consent must be documented in medical record EACH time a virtual check in is performed
• Brief Communication technology is defined as audio-only real-time telephone interactions in addition to synchronous, two-way audio interactions that are enhanced with video or other kinds of data transmission  
  • Does not include messaging on a portal
• Beneficiaries are financially liable for sharing in the cost of these services
• No frequency limits for CY 2019
  • URGE CAUTION regarding overutilization of this service as this service is being monitored
• No service-specific documentation requirements BUT-
• Must be medically reasonable and necessary

SAMPLE Note:

NameDOB

DOSMR#

Last seen by Dr. __________

Mr. Smith contacted the office today via telephone to talk with Dr. X about his change of medication from ABC to DEF. Mr. Smith verbally agreed to a brief communication with me personally to determine if he needs to be seen for a face to face visit. Mr. Smith indicated no concerns with the medication change and felt ____________ was appropriate. I asked Mr. Smith ___________ and confirmed _______ and __________. No face to face visit is required. Plan to follow up in 3 months unless ______ and or ___________ have a cause for concern. Total time spent with patient was ___________.

ABC Endocrinologists, MD

Code G2012 can NOT be reported:

• If communication originates from a related E/M service provided within the previous 7 days by the same physician or other qualified health care professional code
• When communication leads to an E/M service with the same physician or other qualified health care professional (would be bundled into E/M code)
• If there is a telephone evaluation and management service by a physician or other qualified health care professional (who reports evaluation and management services provided to an established patient, parent, or guardian) but is not originating from a related E/M service provided within the previous 7 days nor leads to an E/M service or procedure within the next 24 hours or soonest available appointment is 5-10 minutes of medical discussion CPT code 99441 should be reported.
• Check-ins provided by nurses and other clinical staff continue to be included in E/M visits

Reference: CMS Physician Fee Schedule document

AACE Disclaimer: Comments, information or advice (collectively referred to as “information”) provided by the coding specialists and staff at the American Association of Clinical Endocrinologists (AACE) reflect our organization’s current understanding of the proper use and application of CPT®1, ICD, HCPC codes, and claims modifiers. The information provided is solely intended as general information and has been based on the limited comments provided by the requestor. Ultimately, it is the provider’s responsibility to determine medical necessity, and to correctly submit appropriate codes, charges, and modifiers for services that are rendered. The coverage and payment requirements of both government and private payor plans are quite complex, often vary and are subject to frequent change. Any information provided by AACE or its staff is intended as general guidance only. AACE and its staff cannot make any representations regarding the appropriateness of use or the likelihood of reimbursement with respect to a specific code. Any information provided by AACE and its staff is for informational purposes only and is not meant as a substitute for professional medical and/or legal advice, both of which should be obtained independently from qualified professionals.

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