How To Use HCPCS Code G2061

HCPCS code G2061 describes a qualified nonphysician healthcare professional online assessment and management service for an established patient, for up to seven days, with a cumulative time of 5-10 minutes. This code was terminated on December 31, 2020, and is effective from January 01, 2021. It falls under the category of medical care and is priced based on carrier judgment.

1. What is HCPCS G2061?

HCPCS code G2061 is used to identify a specific type of online assessment and management service provided by qualified nonphysician healthcare professionals. This service is intended for established patients and can be provided for a cumulative time of up to seven days, with each session lasting between 5-10 minutes.

2. Official Description

The official description of HCPCS code G2061 is “Qualified nonphysician healthcare professional online assessment and management service, for an established patient, for up to seven days, cumulative time during the 7 days; 5-10 minutes.” The short description for this code is “Qual nonmd est pt 5-10m.”

3. Procedure

1. The provider initiates the online assessment and management service for an established patient.
2. They review the patient’s medical history, symptoms, and any relevant documentation.
3. Based on the information provided, the provider assesses the patient’s condition and determines the appropriate course of action.
4. The provider may communicate with the patient through secure messaging, video conferencing, or other online platforms.
5. During the assessment and management service, the provider may provide advice, recommendations, or referrals to other healthcare professionals if necessary.
6. The cumulative time spent on the service should not exceed seven days, with each session lasting between 5-10 minutes.

4. When to use HCPCS code G2061

HCPCS code G2061 should be used when a qualified nonphysician healthcare professional provides an online assessment and management service for an established patient. This code is applicable when the cumulative time spent on the service does not exceed seven days, with each session lasting between 5-10 minutes.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G2061, healthcare providers need to document the following:

• Proof of the patient’s established status
• Documentation of the online assessment and management service provided
• Details of the cumulative time spent on the service, ensuring it does not exceed seven days

6. Historical Information and Code Maintenance

HCPCS code G2061 was added to the Healthcare Common Procedure Coding System on January 01, 2020. It has an effective date of January 01, 2021. As of now, no maintenance actions have been taken for this code, as indicated by the action code N, which means no maintenance for this code.

7. Medicare and Insurance Coverage

The coverage of HCPCS code G2061 may vary depending on the payer. Medicare and other insurance providers may have specific guidelines and policies regarding the reimbursement of online assessment and management services. It is important to check with the respective payer for coverage and reimbursement details.

8. Examples

Here are five examples of scenarios where HCPCS code G2061 may be billed:

1. An established patient schedules an online appointment with a qualified nonphysician healthcare professional for a follow-up assessment and management of a chronic condition. The session lasts for 8 minutes, and the cumulative time over seven days does not exceed the limit.
2. A patient seeks an online consultation with a qualified nonphysician healthcare professional for a minor acute illness. The session lasts for 6 minutes, and the cumulative time over seven days does not exceed the limit.
3. An established patient requires ongoing monitoring and management of a mental health condition through online sessions with a qualified nonphysician healthcare professional. Each session lasts for 10 minutes, and the cumulative time over seven days does not exceed the limit.
4. A patient receives online counseling and guidance from a qualified nonphysician healthcare professional for smoking cessation. The session lasts for 7 minutes, and the cumulative time over seven days does not exceed the limit.
5. An established patient with a complex medical condition undergoes an online assessment and management service with a qualified nonphysician healthcare professional. The session lasts for 9 minutes, and the cumulative time over seven days does not exceed the limit.