Ama Policy

Medicare Reimbursement of Telephone Consultations H-390.889

10/16/2019
Fee Schedules

It is the policy of the AMA to: (1) support and advocate with all payers the right of physicians to obtain payment for telephone calls not covered by payments for other services;

(2) continue to work with CMS and the appropriate medical specialty societies to assure that the relative value units assigned to certain services adequately reflect the actual telephone work now performed incident to those services;

(3) continue to work with CMS, other third party payers and appropriate medical specialty societies to establish the criteria by which certain telephone calls would be considered separate services for payment purposes;

(4) request the CPT Editorial Panel to identify or consider developing the additional service code modifiers that may be required to certify specific types of telephone calls as separate from other services; and

(5) seek enactment of legislation as needed to allow separate Medicare payment for those telephone calls that can be considered discrete and medically necessary services performed for the patient without his/her presence.

Policy Timeline

CMS Rep. N, A-92 Reaffirmed: Res. 122, I-97 Reaffirmation A-99 Reaffirmation I-99 Reaffirmation A-01 Reaffirmation A-07 Reaffirmed in lieu of Res. 824, I-11