Telehealth CPT codes and COVID-19 CPT codes
CPT Codes for COVID-19 testing
U0001: Used specifically by the CDC for testing patients for COVID-19
U0002: Allows laboratories to bill for non-CDC lab tests for COVID-19
87635: SARS-CoV-2 (COVID-19); amplified probe technique (naso-pharyngeal swab)
ICD Codes for COVID-19 testing
U07.1 – COVID-19, virus identified is assigned to a disease diagnosis of COVID-19 confirmed by laboratory testing.
U07.2 – COVID-19, virus not identified is assigned to a clinical or epidemiological diagnosis of COVID-19 where laboratory confirmation is inconclusive or not available.
Telehealth billing guidance for major insurances
Category | Required Connection | Effective Date | Coverage Period | Member Cost-Share | Billing Guidance | Products Covered | Code Coverage |
| Telehealth (Audio+Video) | Audio+Video | March 17, 2020 | 90 days | Waived for all services during the effective period | Place of Service “02”; append modifier “GT” to applicable CPT/HCPCS code(s) | All plans and products | E/M codes 99201-99215 |
Telephonic | Audio only | March 17, 2020 | 90 days | Waived for all services during the effective period | Place of Service “02”; append appropriate modifier | All plans and products, except for MEDICAID | 99441-99443 |
Please check the below link for more detail
Category | Required Connection | Effective Date | Coverage Period | Member Cost-Share | Billing Guidance | Products Covered | Code Coverage |
| Telehealth | Audio & Visual | 17-Mar-20 | December 31, 2020 | Waived for COVID-19 treatment; Anthem will leave patient cost-sharing for services not related to COVID-19 | Submit with the CPT code rendered; Place of Service 11; and append either modifier “95”. | Fully Insured Employer Plans; Individual Plans; Medicare Plans. Self-Insured Groups may opt out of this coverage | 99201-99215; 99381-99397; G0438; G0439 |
| Telephonic Only | Audio | 19-Mar-20 | December 31, 2020 | Waived for COVID-19 treatment; Anthem will leave patient cost-sharing for services not related to COVID-19 | Fully Insured Employer Plans; Individual Plans; Medicare Plans. Self-Insured Groups may opt out of this coverage | 99441-99443; G2010; G2012; 98966, 98967, 98968 |
Please check the below link for more detail.
Category | Required Connection | Effective Date | Coverage Period | Member Cost-Share | Billing Guidance | Products Covered | Code Coverage |
| Telehealth | Audio & Visual | 4-Mar-20 | Aetna’s liberalized telemedicine regulations for Commercial plans will remain until August 4, 2020; waived cost-sharing for Commercial plans ends June 4, 2020–except for Behavioral Health services which will continue to September 30, 2020. For MEDICARE ADVANTAGE, cost-sharing is waived for virtual Primary Care and Behavioral Health services through September 30, 2020. | Waived, if related to testing/treatment of COVID-19; Diagnosis code(s) on claim will indicate COVID-19 | Applicable modifiers “GT” or “95” | Fully Insured Employer Plans; Individual Plans; Medicare Plans. Self-Insured Groups may opt out of this coverage | 99201-99215; 99241-99245; G0438; G0439 |
| Telephonic Only | Audio | 4-Mar-20 | Medicare Advantage plans through September 30, 2020. | Waived, if related to testing/treatment of COVID-19; Diagnosis code(s) on claim will indicate COVID-19 | Applicable modifiers “GT” or “95” | Medicare Plans. | 99441-99443; G2010; G2012 |
Please check the below link for more detail.
Category | Required Connection | Effective Date | Coverage Period | Member Cost-Share | Billing Guidance | Products Covered | Code Coverage |
| Telehealth | Audio & Visual | 10-Mar-20 | End of Calendar year 2020 | Waived, for all telehealth services for In-network providers | POS code “11”; modifier 95 | Individual & Group Medicare Advantage Members and Commercial Employer-Sponsored Plans | Following CMS guidelines |
| Telephonic Only | Audio | 10-Mar-20 | End of calendar year 2020 | Waived, for all telehealth services for In-network providers | Following CMS guidelines | Medicare | Following CMS guidelines |
Please check the below link for more detail.
https://docushare-web.apps.cf.humana.com/Marketing/docushare-app?file=3923140
Category | Required Connection | Effective Date | Coverage Period | Member Cost-Share | Billing Guidance | Products Covered | Code Coverage |
| Telehealth | Audio & Visual | 17-Mar-20 | For COVID-19 related testing/treatment, waived through July 24, 2020. For all other In-Network services, hrough September 30, 2020 for MEDICARE ADVANTAGE | For COVID-19 related testing/treatment, waived through July 24, 2020. For all other services, waived for all until September 30, 2020 for Medicare Advantage Members | POS code “11” and either “95” or “GT” modifier | Medicare Advantage | 99201-99215; G0438; G0439 |
| Telehealth | Audio & Visual | 17-Mar-20 | July 24, 2020 | For COVID-19 related testing/treatment cost share is waived through July 24, 2020. | POS code “11” and either “95” or “GT” modifier | Commercial Plans (this includes telephonic only services and online patient portal services) | 99201-99215; G0438; G0439 |
| Telephonic Only | Audio | September 30, 2020 | POS code “11” and either “95” or “GT” modifier | Medicare Advantage | 99201-99215; G0438; G0439; G2010; G2012 | ||
| Electronic Visit | Online Patient Portal | September 30, 2020 | For established patients; unrelated to a medical visit within the previous 7 days or resulting in a medical visit within the next 24 hours. | Medicare Advantage | 99421-99423 & G2061-G2063 |
Please check the below link for more detail.
Category | Required Connection | Effective Date | Coverage Period | Member Cost-Share | Billing Guidance | Products Covered | Code Coverage |
| Telehealth | Audio & Visual | 2-Mar-20 | Through July 31, 2020 | Waived for suspected/confirmed COVID-19 cases/Usual cost-shares will apply for all other diagnoses | POS code “11”; append either “95” or “GT” modifier | Commercial Plans | CPT codes 99201-99215 |
| Virtual Screening telephone consult | Audio | 2-Mar-20 | Through July 31, 2020 | Waived for all diagnoses | Commercial Plans | G2012 | |
| Virtual Care for Therapy Services | Audio & Visual | 2-Mar-20 | Through May 31, 2020 | Patient cost-share will apply | Bill using designated codes for physical; occupational, and speech therapy codes with a “GQ” modifier and standard POS code. | Commercial Plans | Physical Therapy (97161, 97162 & 97110). Occupational Therapy (97165, 97166, 97110). Speech Therapy (92507, 92526) |
Please check the below link for more detail.
Required Connection | Effective Date | Coverage Period | Member Cost-Share | Billing Guidance | Products Covered | Code Coverage |
| Audio & Visual | 03/17/2020 | TBD | DCH announced starting May 1, 2020 ALL co-payments would be suspended for any service, telehealth or in-office; member cost-share will be waived for COVID-19 related services occuring on or after March 18, 2020. | POS code “02” and modifier “GT” | Medicaid, PSHP, PeachCare for Kids | 99201-99215 |
| Audio only | 03/18/2020 | TBD | DCH announced starting May 1, 2020 ALL co-payments would be suspended for any service, telehealth or in-office; member cost-share will be waived for COVID-19 related services occuring on or after March 18, 2020. | Medicaid, PSHP, PeachCare for Kids | 99441-99443 |
Please check the below links for more detail.
Medicaid: https://medicaid.georgia.gov/covid-19
PSHP: https://www.pshpgeorgia.com/newsroom/telehealth-services—covid-19-updates.html
Category | Required Connection | Effective Date | Coverage Period | Member Cost-Share | Billing Guidance | Products Covered | Code Coverage |
| Telehealth | Modalities include telephone communication, use of webcam or other audio and video technology and video cell phone use technology | March 20, 2020 | June 30, 2020 | Waived for testing/treatment related to COVID-19 | POS “02”; Modifier “GT” | All plans and products | Any services that can be delivered virtually will be eligible for telehealth coverage provided the service is “medically necessary”. |