AMA publishes CPT guidance on reporting COVID-19 visits

The American Medical Association (AMA) announced on March 26  new CPT coding and reporting guidance for physicians and medical practices, intended to simplify reporting of in-person and online visit services for novel coronavirus (COVID-19) patients.

The new guidance includes 11 scenarios to help healthcare professionals select the most specific CPT codes for services administered to patients diagnosed with COVID-19 and patients suspected of having the virus. Notably, the last two scenarios address CPT coding for telehealth encounters unrelated to COVID-19.

Specifically, the AMA includes step-by-step instructions for reporting the following scenarios:

• Scenario one: Patient comes to the office for an E/M visit and is tested for COVID-19 during the visit
• Scenario two: Patient comes to the office for an E/M visit for COVID-19 and is directed to a testing site
• Scenario three: Patient received a telehealth visit for COVID-19 and is directed to come to a physician office or a physician’s group practice site for testing
• Scenario four: Patient received a telehealth visit for COVID-19 and is directed to unaffiliated testing site
• Scenario five: Patient receives a virtual check-in or an online visit for COVID-19 (not related to an E/M visit) and is directed to come to the physician office for testing
• Scenario six: Patient receives a virtual check-in or an online visit for COVID-19 (not related to E/M visit) and is directed to an unaffiliated testing site
• Scenario seven: Telehealth visit for a COVID-19 diagnosed patient
• Scenario eight: Patient with COVID-19 receives a virtual check-in,  an online visit via a patient portal or email (not related to an E/M visit), or a telephone call from qualified nonphysician (those who may not report E/M)
• Scenario nine: Physician orders remote physiologic monitoring following patient quarantined at home after receiving COVID-19 diagnosis
• Scenario 10 (non-COVID-19 case): Telehealth visit for a non-COVID-19 patient
• Scenario 11 (non-COVID-19 case): Patient receives a virtual check-in or online visit via patient portal/email (not related to E/M visit) or a telephone call from qualified nonphysician (those who may not report E/M)

The AMA also published a quick-reference flowchart that outlines CPT reporting for COVID-19 testing and created a webpage devoted to information on CMS payment policies and regulatory flexibilities related to COVID-19.