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The service period for online digital E/M services includes all related work within a 7-day period by the reporting individual and other qualified healthcare providers (QHPs) in the same group practice.The 7-day period begins with the reporting provider’s initial, personal review of the patient-generated inquiry.Įxception: If within 7 days of a previous E/M visit that addressed a different problem, the patient sends an initial online digital inquiry for a new problem, the online digital E/M service may be reported separately.When multiple online E/M services addressing different problems occur within a 7-day period, report the cumulative time of service for all problems addressed.This could mean that your billing department should hold the initial e-visit for seven days to ensure all of the time is captured for that period.

Provider is making a clinical decision that typically would have been provided in the office (eg, medication dose adjustment, ordering of a test, or prescription of a new medication).

Patient has a new/unrelated problem within seven days of a previous E/M visit when a different problem was addressed.

Patient is not in a global period for the same or similar condition.

Clinician hasn’t seen the patient within 7 days.

The 2021 E/M guidelines for a visit are met.

Time spent by the provider to respond is >5 minutes.

The patient is established to the provider.

Patient consents to the e-visit and understands that s/he might be billed.

A provider is answering a patient-initiated message through the patient portal.In other words, the provider is making a clinical decision that typically would have been provided in the office (eg, medication dose adjustment, ordering of a test, or prescription of a new medication).īelow are the Do's and Don’ts of billing these types of visits.Ĭan bill an E-visit when ALL of the following are met: An Evaluation and Management service (E/M) needs to be performed in order to bill for the service. E-visits are utilized specifically for responding to patient-initiated health concerns and medical questions, and a provider’s management of the patient’s care utilizing communication through a patient portal.While on-line communication is utilized more and more, e-visits should not be utilized for simply disseminating test results, processing medication requests, or scheduling an appointment. Q: The providers in our clinic want to start billing e-visits.Can they bill for all the communication between the provider and patient through our online portal?Ī: As you venture into billing e-visits, on-line visits, digital visits – however you’d like to refer to them – let’s review the required elements for these types of services.