Qualified health care professionals (QHPs) — including psychologists — can receive reimbursement for time spent on audio-only telephone services if a patient calls because they are experiencing mental health issues or symptoms.
Telephone assessment and management services are patient-initiated non-face-to-face services provided by a QHP to a patient, parent, or guardian via real-time phone conversation. The services are billed using CPT® codes 98966, 98967, and 98968. Confirm access to these codes with your third-party payer prior to usage.
Telephone assessment and management services are not considered telehealth services; therefore, real-time audio/visual equipment is not required.
Typically, these calls involve:
- Obtaining a patient history
- Assessing the patient's condition
- Making a medical decision
- Communicating that decision via the phone with the patient
Psychologists should document the cumulative time spent on these services as they may only be reported once during a seven-day period (i.e. if more than one telephone call is required to complete the consultation request, the entirety of the service and the cumulative discussion and information review time should be reported with a single code). The nature of the service and other pertinent information should also be documented in the medical record (see below).
If the telephone call is in reference to a service performed and reported by the provider within the previous seven days, the telephone service codes cannot be reported. Further, if the telephone call results in the decision to see the patient within 24 hours, the telephone service cannot be reported, as it would be considered part of the subsequent visit.
Telephone assessment and management codes were built for relatively brief and directed services and, therefore, reimburse at a significantly lower rate when compared to services used for delivering ongoing therapy. For example, CPT code 90832, which is used to report 30 minutes of face-to-face psychotherapy, has a work RVU (wRVU) of 1.50.