New Online Digital E/M Service Codes for 2020 #PACPearls

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PAC Pearls from the Women’s Dermatologic Society

New Online Digital Evaluation and Management (E/M) Services Codes went into effect on January 1, 2020. Please keep in mind that there are many provisions, which take up a full page in the 2020 CPT book, that have to be met in order to use the codes. Below is a summary of the main points.

 2020 Online Digital E/M Service Codes to Note


  • 99421: Online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 5-10 minutes 
  • 99422: 11-20 minutes 
  • 99423: 21 or more minutes


Patient Initiated Codes

These codes are for established patients only, and must be patient initiated. The patient has to initiate it through a HIPAA compliant platform or secure email. It cannot deal with administrative issues, but rather must have some patient complaint that must not be related to any complaint dealt with by an office visit within the last 7 days. 

If the complaint deals with a surgical procedure, and they are in the surgical global period, then you CANNOT bill these. The codes themselves have a “built-in” global period, meaning if there is an online “conversation” with the patient over a 7 day period, you only report one code- but you DO add up the times. And if you actually see the patient within 7 days, you can add the time spent into your E/M calculation (this may be more relevant in 2021 with new E/M paradigm, but that’s for another pearl).

What about Valuations?

2020 Physician Fee Schedule
CPT Code
RVUs
2020 Payment
99421
5-10 min
0.43
$15.52
99422
11-20 min
0.86
$31.04
99423
21+ min
1.39
$50.16


The Women’s Dermatologic Society (WDS) Practice Advisory Committee supports WDS members at any stage of their career looking to manage or start their own practice by offering resources on navigating the practice environment.


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