6 new digital health CPT codes that you should know about

Kevin B. O'Reilly , Senior News Editor

Six new codes that are part of the 2020 Current Procedural Terminology (CPT®) code set will help physicians and others report a range of digital health services including electronic visits through secure patient portal messages.

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The new codes are spurred by digital health tools that are growing in popularity, such as patient portals. These tools enable patients and physicians to connect asynchronously and outside of face-to-face settings, making it easier for patients with transportation and scheduling barriers to get questions answered and receive care.

The new CPT codes report online digital evaluation services, or e-visits. The codes describe patient-initiated digital communications provided by physicians or other qualified health professionals—codes 99421, 99422 and 99423. Three others describe similar interactions when they involve a nonphysician health professional—98970, 98971 and 98972.

Along with these six new, there are another 242 new CPT codes in the 2020 set approved by the CPT Editorial Panel, which considered broad input from physicians, medical specialty societies and the greater health care community. Two of these new codes also will enable patients to take part in their care while at home. Codes 99473 and 99474 have been added to support home blood-pressure monitoring that enables physicians to better diagnose and manage hypertension—and helps patients to take an active role in the process.

“With the advance of new technologies for e-visits and health monitoring, many patients are realizing the best access point for physician care is once again their home,” said AMA President Patrice A. Harris, MD, MA. “The new CPT codes will promote the integration of these home-based services that can be a significant part of a digital solution for expanding access to health care, preventing and managing chronic disease, and overcoming geographic and socioeconomic barriers to care.”

Along with the new codes, there are 71 deletions and 75 revisions in the 2020 code set. Here are some other notable changes.

Codes for health and behavior assessment and intervention services—96156, 96158, 96164, 96167, 96170, and add-on codes 96159, 96165, 96168, 96171. These codes replace six older codes to more accurately reflect current clinical practice that increasingly emphasizes interdisciplinary care coordination and teamwork with physicians in primary care and specialty settings.

Significant enhancement in the codes for reporting long-term electroencephalographic (EEG) monitoring services—95700–95726. Four older codes were deleted to make way for 23 new codes that provide better clarity around the services performed by a technologist and those performed by a physician or another qualified health care provider.

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The new CPT category I codes are effective for reporting starting Jan. 1, 2020.

For a better understanding of the latest revisions to the CPT code set, rely on the new guide, CPT® Changes 2020: An Insider's View. The AMA is the authority to turn to when seeking an official interpretation and explanation for a CPT® code or guideline change.

Join the AMA’s coding-and-documentation experts in Chicago, Nov. 19–22, for the Outpatient CDI Workshop & CPT and RBRVS 2020 Annual Symposium, to stay up to date on significant CPT code and relative value unit (RVU) changes for 2020. Arrive early to develop mastery of outpatient clinical documentation improvement (CDI) at the one-day workshop.

The 2020 CPT codes and descriptors can be imported straight into existing claims and billing software using the downloadable CPT 2020 Data File. The file contains the updated code set’s complete descriptor package, including official descriptors for consumers and physicians, and the official CPT coding guidelines.

Editor’s note: This story was originally published with the headline, “6 new telehealth CPT codes that you should know about.” Telehealth is a narrower term that specifically describes two-way audio visual interactions, and is encompassed under the broader framework of digital health.