Online Assessment and Management Services (e-Visits)

Qualified health care professionals (QHPs) — including psychologists — can receive reimbursement for specific non-face-to-face services conducted through electronic health record (EHR) portal messages or other HIPAA-compliant, secure platforms. Confirm access to these codes with your third-party payer prior to usage.

Online assessment and management services, or e-visits, are patient-initiated digital communications that require professional patient assessment and decision making to generate subsequent management of the patient. 

These services include: 

• Review of the initial inquiry.
• Review of patient records or other information relevant to assessment of the patient’s problem.
• Interaction with clinical staff focused on the patient’s problem, if needed.
• Development of management plans, including:

○ Feedback on patient’s current functioning, treatment and/or intervention modifications, and plan for monitoring and follow-up.

○ Subsequent communication with the patient through online, telephone, email, or other digitally supported communication. 

These services are not for nonevaluative/nonassessment communication of test results, scheduling of appointments, or other communication that does not include assessment and management. 

Psychologists should document the cumulative time spent on these services as they may only be reported once during a seven-day period beginning with their initial review of the patient-generated inquiry. If part of a group practice, the cumulative time reported should include time spent by all QHPs in the group who devote time to the patient’s e-visit. 

Additionally, e-visits require documentation and permanent storage (electronic or hardcopy) of the encounter.

• Do not report e-visit services for less than five minutes.
• Report e-visit services once per seven-day period.
• Do not count G2061, G2062 or G2063 time otherwise reported with other services.
• Do not use e-visit service codes if the initial inquiry from the patient comes within seven days of a previous treatment or service that both relate to the same problem.
• Similarly, do not use e-visit service codes if the initial inquiry from the patient occurs within the post-treatment period of a previously completed procedure.
• If the initial inquiry from the patient comes within seven days of another treatment or assessment service, you can only use e-visit service codes if the inquiry addresses a different problem.
• If the patient presents a new, unrelated problem within the seven-day period of an e-visit service, add time spent on the assessment and management of the additional problem to the cumulative service time.

Example #1

A mother submits an online query through her child’s psychologist’s Electronic Health Record (EHR) portal about her 12-year-old son who is being treated for Generalized Anxiety Disorder with concerns that her son’s anxiety is worsening. Upon assessing the symptoms outlined on the patient query, the child’s psychologist responds via the EHR portal and requests that the mother upload the patient’s daily anxiety ratings and activity log through the portal and also asks several other pertinent questions related to the patient’s social, school and family functioning and interactions. Upon review of the mood ratings, activity log and the additional clinical history, the psychologist determines that the patient’s anxiety is stable and not interfering with daily functioning. The psychologist saves the clinical documentation in the Electronic Medical Record (EMR) as an e-visit encounter to support reporting a professional claim. 

Total cumulative time spent by the psychologist for the entire service is 10 minutes. 

One unit of G2061 is billed.

Example #2

A 65-year-old patient with a Pain Disorder submits an online query through her psychologist’s EHR portal about her increase in pain and having to miss work. Upon assessing the symptoms outlined on the patient query, the patient’s psychologist responds through the portal assessing pain rating and depressive symptoms in case they warrant an in-person office or emergency department (ED) visit. Subsequent to the patient’s reassuring response, the psychologist follows up online regarding use of cognitive/behavioral techniques the patient has been previously taught and instructs patient to use these techniques. Several hours later, after employing the cognitive/behavioral techniques, the patient provides her psychologist with a symptoms update along with pre-and post-treatment pain and functioning ratings.

The next day, the patient forwards via the portal a status update that reflects reduced pain but reluctance to go to work for fear of aggravating pain. The psychologist then sends the patient a pain/physical activity/catastrophic thoughts handout with a request for the patient to complete a pain/activity/cognitions tracking form for the day. On the third day, the patient provides the psychologist with a follow-up portal message stating that symptoms are improving and that the patient was able to go to work. The psychologist saves the clinical documentation in the EMR as an e-visit encounter to support reporting a professional claim. 

Total cumulative time spent by the psychologist for the entire service is 15 minutes.

One unit of G2062 is billed.

Example #3

A father submits an online query through his child’s psychologist’s EHR portal about his 10 -year-old son who has ADHD with increased behavioral difficulties. Upon assessing the symptoms outlined on the patient query, the child’s psychologist responds via the EHR portal and requests that the father upload a completed parent follow-up ADHD standardized assessment scale. The psychologist reviews the standardized score and asks the father via the EHR portal several questions related to his son’s behavior at home and school, as well as about interactions with peers and other adults. With the additional clinical history received from the father, the psychologist assesses that the ADHD is well-controlled at home but not at school.

The psychologist provides the father with a list of behavioral strategies the father can discuss with the child’s teacher and instructs him to follow-up via the portal within five days and to provide a teacher-completed ADHD assessment scale during that time. Five days into the e-visit, the father and psychologist reconnect to assess the child’s symptoms, assess a follow-up parent-completed assessment scale, and review the teacher’s assessment scale. Through both portal and phone communication, the psychologist and father agree that symptoms are better controlled at school with the implementation of behavioral strategies at school and increased communication between father and teacher. The psychologist instructs the father to schedule a follow-up office visit in one month for ADHD reassessment. The psychologist saves the clinical documentation in the EMR as an e-visit encounter to support reporting a professional claim. 

Total cumulative time spent by the psychologist for the entire service is 25 minutes.

One unit of G2063 is billed.