How To Use HCPCS Code G2012

HCPCS code G2012 describes a brief communication technology-based service provided by a physician or other qualified health care professional to an established patient. This service, also known as a virtual check-in, allows for a quick medical discussion without the need for an in-person visit. In this article, we will explore the details of HCPCS code G2012, including its official description, procedure, when to use it, billing guidelines, historical information, Medicare and insurance coverage, and provide examples of when this code should be billed.

1. What is HCPCS G2012?

HCPCS code G2012 is a specific code used to identify a brief communication technology-based service provided by a physician or other qualified health care professional. This service allows for a virtual check-in with an established patient, where a medical discussion takes place without the need for an in-person visit. The duration of this check-in typically ranges from 5 to 10 minutes.

2. Official Description

The official description of HCPCS code G2012 is as follows: “Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion.” The short description for this code is “Brief check-in by md/qhp.”

3. Procedure

1. The provider initiates a virtual check-in with an established patient using a communication technology platform, such as a phone call or secure video conferencing.
2. During the check-in, the provider engages in a medical discussion with the patient, addressing any concerns or questions they may have.
3. The duration of the check-in should be between 5 to 10 minutes.
4. The provider may document the details of the check-in and any relevant findings or recommendations.

4. When to use HCPCS code G2012

HCPCS code G2012 should be used in the following contexts:

• The patient is an established patient, meaning they have previously received care from the provider.
• The check-in is not related to an evaluation and management service provided within the previous 7 days.
• The check-in does not lead to an evaluation and management service or procedure within the next 24 hours or the soonest available appointment.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G2012, healthcare providers should ensure the following:

• Document the date and duration of the virtual check-in.
• Include a summary of the medical discussion and any recommendations provided to the patient.
• Ensure that the patient is an established patient and meets the criteria for using this code.

6. Historical Information and Code Maintenance

HCPCS code G2012 was added to the Healthcare Common Procedure Coding System on January 01, 2019. As of the effective date, there have been no maintenance actions taken for this code, indicated by the action code N, which means no maintenance for this code.

7. Medicare and Insurance Coverage

Medicare and other insurance providers may cover the virtual check-in service described by HCPCS code G2012. The pricing indicator code for this code is 13, which means the price is established by carriers. The multiple pricing indicator code is A, indicating that it is not applicable as HCPCS is priced under one methodology. Providers should check with individual payers to determine coverage and reimbursement rates.

8. Examples

Here are five examples of when HCPCS code G2012 should be billed:

1. A patient contacts their primary care physician via secure video conferencing to discuss a recent change in symptoms and receive guidance on managing their condition.
2. A specialist follows up with a patient after a recent procedure to check on their recovery progress and address any concerns or complications.
3. A patient reaches out to their psychiatrist for a brief medication adjustment discussion via a phone call.
4. A provider conducts a virtual check-in with a patient who is experiencing side effects from a recently prescribed medication.
5. A patient contacts their dermatologist to discuss the progress of their treatment plan and receive recommendations for ongoing care.