Anthem Blue Cross and Blue Shield | Medicare AdvantageMarch 31, 2023
E-visits
Medicare Advantage allows coverage of online evaluation and management services for an established patient when all requirements have been met. The communication between patient and doctor is a cumulative of seven days and with at least the minimum of the minutes for the CPT® code being billed. Any services amounting to less than five minutes would not be appropriate to bill as an e-visit.
CPT code | Description |
99421 | Online digital evaluation and management service, for an established patient, for up to seven days, cumulative time during the seven days; 5 to 10 minutes |
99422 | Online digital evaluation and management service, for an established patient, for up to seven days, cumulative time during the seven days; 11 to 20 minutes |
99423 | Online digital evaluation and management service, for an established patient, for up to seven days, cumulative time during the seven days; 21 or more minutes |
98970 | Qualified nonphysician healthcare professional online digital assessment and management, for an established patient, for up to seven days, cumulative time during the seven days; 5 to 10 minutes |
98971 | Qualified nonphysician healthcare professional online digital assessment and management, for an established patient, for up to seven days, cumulative time during the seven days; 11 to 20 minutes |
98972 | Qualified nonphysician healthcare professional online digital assessment and management, for an established patient, for up to seven days, cumulative time during the seven days; 21 or more minutes |
Here is a communication by CMS to help with further questions:
https://www.cms.gov/newsroom/fact-sheets/medicare-telemedicine-health-care-provider-fact-sheet.
MEAMH-CR-016638-23-CPN16365
PUBLICATIONS: April 2023 Provider News - Maine
To view this article online:
Visit https://providernews.anthem.com/maine/articles/e-visits-3-12992
Or scan this QR code with your phone