New and Amended Telehealth Infectious Disease Fee Codes

Ashley Lane
August 19, 2021

The Infectious Diseases section of the Payment Schedule has new and amended Telehealth Infectious Disease fee items starting September 1st, 2021. If you work in this specialty, you’ll want to continue reading to learn about the updates that pertain to you.

1. 33635 – Telehealth Infectious Disease Care Management of HIV/AIDS

– per half hour or major portion thereof 

Payable rate: $102.36

This fee code only applies to services submitted under diagnostic codes 042, 043, and 044 and is only payable to Infectious Disease specialists. Only the larger fee is eligible for payment if the service is provided in addition to a visit, counselling, or consultation. Be sure to include the start and end times on both the claim and the patient’s chart. If a service is under 15 minutes, there is an appropriate visit fee item that it should be billed under.

2. 33640 – Telehealth Infectious Disease Extended Consultation for complex infectious diseases issues

(antibiotic-resistant organisms, outbreak management/infection control, tropical disease management only when requested by another Infectious Diseases Specialist, Internist, Internal Medicine Sub-Specialist, Pediatricians and Anesthesiologists).

This fee code includes the history, physical examination, review of X-rays and additional visits necessary to provide a written report.

Payable rate: $335.29

This service has a minimum time requirement of 75 minutes physically spent with the patient. Be sure to include the start and end times on both the claim and the patient’s chart. If the referral to the Infectious Diseases specialist comes from a physician aside from the specialties listed in the description and the consultation services meet the conditions defined, the claim can be submitted using 33640 including a correspondence/note record detailing medical necessity. Cases such as these will be independently reviewed.

The creation of telehealth equivalent 33655 effectively removed the reference to in and out of office visits from its title. The amendment is as follows:

3. 33645 –  Infectious Disease Care Management of HIV/AIDS

– per half hour or major portion thereof

This fee code only applies to services submitted under diagnostic codes 042, 043, and 044 and is only payable to Infectious Disease specialists. Only the larger fee is eligible for payment if the service is provided in addition to a visit, counselling, or consultation. Be sure to include the start and end times on both the claim and the patient’s chart. If a service is under 15 minutes, there is an appropriate visit fee item that it should be billed under.

The fee items listed above have also been added to the list of eligible Business Cost Premium (BCP) fee items in the General Preamble C. 27 of the MSC Payment Schedule.

 

Staying up to date with the latest fee items related to your specialty will guarantee you are paid appropriately for your hard work. If you have any questions about this update, please feel free to reach out to our support team for support.