e-Visits:  The Opportunity Missed by PTs

In the 4th quarter, we look for announcements about proposed cuts in reimbursement and/or the elimination of billable codes by CMS and commercial payers. What has seemingly gone unnoticed was the pre-pandemic addition of CPT Codes for Asynchronous ‘e-Visits’.  

The CPT e-visit codes paid under the Medicare Physician Fee Schedule are:

• 98970: Qualified non physician health care professional online assessment and management service, for an established patient, for up to seven days; cumulative time during the seven days, 5-10 minutes. ($12)*
• 98971: As above, 11-20 minutes. ($22)*
• 98972: As above, 21 or more minutes. ($33)*

*Check with your MAC or other payers for your reimbursement rates

Patient and Provider Experience with Asynchronous Visits

–When it is convenient for the patient, they record a video and load it into their patient portal.  They can show home exercise performance, demonstrate a range of motion for measurement, ask questions, etc.

–When it is convenient to the provider, they view the patient-submitted video, and record a video, providing appropriate feedback.  The video is placed in the patient portal.

–When it is convenient for the patient, they view the PT-provided video.  

A self-insured corporation in Washington reports patients are choosing Asynchronous visits 10 to 1 over Synchronous visits.

Examples of e-Visits for you and your patients

-A patient who thinks one of their home exercises is increasing their pain.

-A patient with C-Spine, T-Spine, or Upper Extremity pain who would benefit from an ergonomic assessment of their workspace. 

-A patient with a ‘quick question’.  Previously our choices were:

• Get on the phone, and donate our time
• Tell the front desk to schedule an appointment/tell the patient to wait till their next appointment
• Lose the patient, who is frustrated that they “can’t get a simple question answered”

-A patient who tells you “things are just too crazy on my end to come to PT, or even commit to scheduled ‘Zoom Calls’.”

-A Medicare Insured patient has reached their Annual Cap for PT, but would benefit from continued care (e-Visits do not count toward the Cap)

-A Medicare insured patient is being seen for PT and SLP who is likely to make slow progress.  Use of e-Visits by you and the SLP can support the patient while leaving additional in-person or Synchronous Video Visits for later in their recovery.

So what are the requirements to bill these CPT Codes?  

-e-Visits are “non-face-to-face patient-initiated digital communications that require a clinical decision that otherwise typically would have been provided in the office.” 

-The codes are intended to cover short-term (up to seven days) assessments and management activities

–An e-visit can comprise more than one communication between you and your patient and includes all activities that you perform to meet the assessment and management needs as identified by the patient. The maximum duration of an e-visit is seven days.

–That the e-visit was initiated by the patient.

How do e-Visits NOT reduce my over-all billing?

e-Visits are NOT a replacement for your hands-on care or patients who are appropriate for in-person or Synchronous Video visits.  They are an opportunity to bill for the time we used to ‘donate’, reach patients that would have stopped PT, and build your Brand offering services that others may not.