Medicare Modifier For Telehealth Visit

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What coding modifiers to use for Medicare telehealth

Details: During the COVID-19 crisis, Medicare will pay the non-facility amount for telehealth services when they are billed with the place of service (POS) the physician would have used if the service had

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Billing and coding Medicare Fee-for-Service claims

Details: Append modifier 95 to indicate the service took place via telehealth. The CR modifier is not required when billing for telehealth services. Hospital billing for remote visits. Hospitals can bill HCPCS code Q3014, the originating site facility fee, when a hospital provides services via telehealth to a …

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› Url: https://telehealth.hhs.gov/providers/billing-and-reimbursement/billing-and-coding-medicare-fee-for-service-claims/ Go Now

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Telehealth Services - Centers for Medicare & …

Details: Telehealth Services Billing & Payment. Submit professional telehealth service claims using the appropriate CPT or HCPCS code. If you performed telehealth services through an asynchronous telecommunications system, add the telehealth GQ modifier with the professional service CPT or …

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Telehealth Service Modifiers - Novitas Solutions

Details: Telehealth modifiers must be submitted with distant site telehealth services. Generally, interactive audio and video communications must be used to permit real-time communication between distant site physician/practitioner and patient. Patient must be present and participating in telehealth visit. Telehealth modifier defined as "synchronous

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Medicare payment policies during COVID-19 …

Details: Cost-sharing: Providers can reduce or waive patient cost-sharing (copayments and deductibles) for telehealth visits Licensing: Providers can furnish services outside their state of enrollment. For questions about new enrollment flexibilities, or to enroll for temporary billing privileges, use this list of Medicare Administrative Contractors

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› Url: https://telehealth.hhs.gov/providers/billing-and-reimbursement/medicare-payment-policies-during-covid-19/ Go Now

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MEDICARE TELEMEDICINE HEALTH CARE PROVIDER FACT …

Details: MEDICARE TELEHEALTH VISITS: Currently, Medicare patients may use telecommunication technology for office, hospital visits and other services that generally occur in-person. The provider must use an interactive audio and video telecommunications system that permits real-time communication between the distant site and the patient at home.

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› Url: https://www.cms.gov/newsroom/fact-sheets/medicare-telemedicine-health-care-provider-fact-sheet Go Now

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GT Modifier for Telehealth Billing [2021 Guide]

Details: GT Modifier for Telehealth Billing [2021 Guide] The GT modifier is a coding modifier used for Telehealth claims. For many years it was the standard for signifying Telehealth claims before being mainly supplanted by the 95 modifier. In 2018, when CMS and Medicare stopped using this mainly companies followed suit and switched to 95 modifier.

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Modifier 95, GT, QT with telehealth services Medical

Details: Medicare - POS 2 - no modifier (received lower reimbursement) Medicare Telehealth Visits: Effective for services starting March 6, 2020, and for the duration of the COVID-19 Public Health Emergency (PHE), Medicare will make payments for Medicare telehealth services furnished to patients in …

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› Url: https://www.aapc.com/discuss/threads/modifier-95-gt-qt-with-telehealth-services.172183/ Go Now

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2021 Coding for Telehealth, Telephone E/M and Virtual

Details: Medicare rules: •Virtual check-ins are not considered telehealth; do not use modifier 95 •Report POS where the service was provided •For established patients only •Not related to E/M service in past 7 days, or leading to visit within 24 hours or next urgent visit •Use G2010 for reviewing video and/or images from patient

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› Url: https://webfiles.gi.org/links/pm/GarciaSlides.pdf Go Now

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Bill Correctly for Medicare Telehealth Services CMS

Details: Date. 2019-11-07. In a recent report, the Office of Inspector General (OIG) determined that the Centers for Medicare & Medicaid Services (CMS) improperly paid practitioners for some telehealth claims associated with services that did not meet Medicare requirements. CMS released the Medicare Telehealth Services Video to help you bill correctly.

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Telehealth Insurance Coverage - Medicare

Details: Medicare telehealth services include office visits, psychotherapy, consultations, and certain other medical or health services that are provided by a doctor or other health care provider who’s located elsewhere using interactive 2-way real-time audio and video technology.. You can get certain Medicare telehealth services without being in a rural health care setting, including:

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› Url: https://www.medicare.gov/coverage/telehealth Go Now

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Billing for telebehavioral health Telehealth.HHS.gov

Details: See the complete list of telehealth services covered by Medicare during the public health emergency from the Centers for Medicare & Medicaid Services. Audio-only or video telehealth. Although Medicare reimburses for audio and video telehealth, audio-only reimbursement is currently covered only during the COVID-19 public health emergency.

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› Url: https://telehealth.hhs.gov/providers/telehealth-for-behavioral-health/billing-for-telebehavioral-health/ Go Now

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Medicare Telehealth Frequently Asked Questions

Details: those residents in Medicare -covered stays (whose bundled lab tests would be covered instead under Part A’s SNF benefit at §1861(h) of the Act) . Updated: 4/17/20 7. Question: How should a laboratory document the miles traveled to collect a specimen? Answer: An independent laboratory billing Medicare for the travel allowance is …

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› Url: https://www.cms.gov/files/document/medicare-telehealth-frequently-asked-questions-faqs-31720.pdf Go Now

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New Telehealth CMS Billing: March 30 Rule Change Modifier

Details: Medicare Telehealth: Apply Modifier 95 to All Claims. There has been a lot of confusion over what modifier to use when submitting claims for telehealth services with an E/M code such as 99201-99215 (Office visits). The March 31, 2020 COVID-19 National Stakeholder Call provided one uniform method.

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› Url: https://healthcare.trainingleader.com/2020/03/telehealth-cms-billing-modifier-pos/ Go Now

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Telehealth Coding and Billing Compliance Journal Of AHIMA

Details: 95: For telehealth visits conducted in lieu of an intended in person visit due to the COVID-19 pandemic, use modifier 95 to identify telehealth services on professional claims. GQ: For Alaska and Hawaii, the GQ modifier is required on medical telehealth claims that are furnished asynchronously as part of a federal telemedicine demonstration

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› Url: https://journal.ahima.org/telehealth-coding-and-billing-compliance/ Go Now

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List of Telehealth Services CMS - Centers for Medicare

Details: List of services payable under the Medicare Physician Fee Schedule when furnished via telehealth. List of Telehealth Services for Calendar Year 2021 (ZIP) - Updated 08/17/2021

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› Url: https://www.cms.gov/Medicare/Medicare-general-information/telehealth/telehealth-codes Go Now

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New Medicare Law Requires In Person Visit for Telehealth

Details: New Medicare Law Requires In-Person Visit for Telehealth Coverage. In December 2020, the Consolidated Appropriations Act of 2020, section 123 includes language that requires behavioral health providers to have seen their client in person during the prior six months before a telehealth visit will be covered by Medicare.Further, providers must have in-person visits on a “regular interval” to

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› Url: https://telehealth.org/new-medicare-law-requires-in-person-visit-for-telehealth-coverage/ Go Now

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Higher Medicare Reimbursement For Telehealth Fifth

Details: Medicare pays more for telehealth services now than it did before COVID-19. The new payment rates are slated to end, but for now, the rates are firmly in place. Medicare pays more for telehealth services now than it did before COVID-19. The new payment rates are slated to …

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› Url: https://www.fifthavenueagency.com/higher-medicare-reimbursement-for-telehealth/ Go Now

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Using Modifier 95 for Telehealth Makes Cents - AAPC

Details: They say (for Medicare claims) POS 02 must be used on all actual telehealth visits, and with modifier 95 on the CPT code! They also instructed to use 99441-99443 or 99421-99423 time-based codes for AUDIO ONLY visits by phone, with POS 11 and modifier GT. Each commercial insurance seems to have their own twist: Atrio/Aetna: same as CMS

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Telehealth UHCprovider.com

Details: UnitedHealthcare will reimburse appropriate claims for telehealth services in accordance with the member’s benefit plan. Depending on whether a claim is for a Medicare Advantage, Medicaid, self-funded Group Market health plan, or Individual and fully insured Group Market health plan member, those policies may require different modifiers, date of service limitations or place of service

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› Url: https://www.uhcprovider.com/en/resource-library/news/Novel-Coronavirus-COVID-19/covid19-telehealth-services/covid19-telehealth-services-telehealth.html Go Now

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Coding for Phone Calls, Internet and Telehealth

Details: Units, Modifier and Billed Amount; Overview of Four Covered Options for Medicare Part B Patients. There are four options for telehealth and other communications-based technology services. This information is based on guidelines from the Centers for Medicare & Medicaid Services.

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› Url: https://www.aao.org/practice-management/news-detail/coding-phone-calls-internet-telehealth-consult Go Now

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Telehealth Services - Novitas Solutions

Details: Modifiers. Telehealth modifiers must be submitted with distant site telehealth services. Generally, interactive audio and video communications must be used to permit real-time communication between distant site physician/practitioner and patient. Patient must be …

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Telehealth Visits Medicare Advantage - BCBSIL

Details: The Centers for Medicare & Medicaid Services (CMS) is allowing providers to engage in telehealth services with new and established Medicare patients. Visit the CMS website for telehealth guidance and a complete list of telehealth codes. Telehealth Visits CPT ® / HCPCS Codes. 1. Modifier/ Place of Service (POS) Telehealth visits offer the same

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› Url: https://www.bcbsil.com/pdf/education/telehealth_visits_ma_202008.pdf Go Now

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Higher Medicare Reimbursement For Telehealth Primoris

Details: Medicare pays more for telehealth services now than it did before COVID-19. The new payment rates are slated to end when the public health emergency expires, but for now, these rates are firmly in place.

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› Url: https://primoriscredentialingnetwork.com/higher-medicare-reimbursement-for-telehealth/ Go Now

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TELEHEALTH/E-VISIT QUICK REFERENCE GUIDE – April 14, 2020

Details: using GT or 95 modifier AETNA E-VISITS March 26 - June 4th, 2020. CORRECTED 4-14-20 No modifier 98970 98971 . 98972 . G codes for E-Visits: G2061 . G2062 . G2063. Still allowed by PT in policy in addition to telehealth * NOTE: 1. Aetna will pay for institutional providers performing E-Visits (UB04, 780) AETNA MEDICARE ADVANTAGE UPDATED 4-14-20

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› Url: https://www.ppta.org/assets/COVID/PPTA%20Payer%20Update%20Table%20for%20Telehealth%20E-visits%204-14-2020.pdf Go Now

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Medicare Annual Wellness Visit Telehealth Component and

Details: Add place of service code 02 – telehealth – to the appropriate code below for billing telehealth AWVs. AWV HCPCS Codes Billing Code Descriptors G0438 Annual wellness visit; includes a personalized prevention plan of service (PPS), initial visit G0439 Annual wellness visit; includes a personalized prevention plan of service (PPS), subsequent

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Provider: Telehealth and Telemedicine Billing - Humana

Details: ANSWER: Yes, CPT codes 96130-96133, 96136-96139 and 96121 are billable as telehealth services during the COVID-19 public health emergency. Modifier 95 should be used to indicate the service was provided virtually according to Humana policy. Please refer to applicable CMS guidance. , opens new window. , state guidance.

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Telehealth - JF Part B - Medicare - Noridian

Details: Visit Noridian's COVID-19 page for information and guidance related to COVID-19.. Visit the CMS Current Emergencies page for information and updates related to COVID-19 and to access the Accelerated and Advanced Payments Fact Sheet .. To support our providers, a COVID-19 Hotline has been established to help with COVID-19 related inquiries. The hotline number is: 866-575-4067.

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› Url: https://med.noridianmedicare.com/web/jfb/topics/telehealth Go Now

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Telemedicine Medicaid

Details: Medical Codes: States may select from a variety of HCPCS codes (T1014 and Q3014), CPT codes and modifiers (GT, U1-UD) in order to identify, track and reimburse for telemedicine services. Telehealth (or Telemonitoring) is the use of telecommunications and information technology to provide access to health assessment, diagnosis, intervention

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› Url: https://www.medicaid.gov/medicaid/benefits/telemedicine/index.html Go Now

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Medicare Telehealth Services and Registered Dietitians

Details: For telehealth services provided as part of Medicare demonstration projects in Alaska and Hawaii, the GQ (via synchronous telecommunications system) modifier must be used. In addition, the originating site, where the beneficiary receives the service, is eligible to receive a facility fee as described by HCPCS code Q3014.

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Higher Medicare Reimbursement For Telehealth Fifth

Details: Medicare pays more for telehealth services now than it did before COVID-19. The new payment rates are slated to end, but for now, the rates are firmly in place.

› Verified 7 days ago

› Url: https://fifthavenuehealthcareservices.com/higher-medicare-reimbursement-for-telehealth/ Go Now

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Telehealth and Telephonic Payment & Billing Cheat Sheet

Details: Jan 27, 2020 – Jun 30, 2020: For telehealth distant site services that are also FQHC qualifying visits, FQHCs must report three HCPCS/CPT codes: o the FQHC Prospective Payment System (PPS) specific payment o the HCPCS/CPT code that describes the services …

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› Url: https://www.essentialaccess.org/sites/default/files/CPCA-Telehealth-Visit-Cheat-Sheet-Updated-May-8-2020.pdf Go Now

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Medicare and Medicaid policies Telehealth.HHS.gov

Details: For billing related information, see billing and coding Medicare Fee-for-Service claims. Safety-net provider policies Federally Qualified Health Centers and Rural Health Clinics can provide telehealth services to patients wherever they are located — including in their homes — for the duration of the COVID-19 public health emergency.

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› Url: https://telehealth.hhs.gov/providers/policy-changes-during-the-covid-19-public-health-emergency/medicare-and-medicaid-policies/ Go Now

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Telehealth Visits - AAFP Home

Details: Medicare requires audio-video for office visit (CPT 99201-99215) telehealth services. Audio-only encounters can be provided using the telephone evaluation and management codes (CPT codes 99441-99443).

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› Url: https://www.aafp.org/family-physician/patient-care/current-hot-topics/recent-outbreaks/covid-19/covid-19-telehealth/coding-scenarios-during-covid-19/telehealth.html Go Now

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Medicare Proposes New Changes for Telehealth Services in

Details: Nearly half of all Medicare primary care visits in April 2020 were telehealth encounters, a level consistent with health care encounters more broadly. Between mid-March and mid-October 2020, over 24.5 million patients (approximately 40% of all Medicare patients) had received a telemedicine service.

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Telehealth Billing for Therapists: The Definitive Guide [2021]

Details: These codes are approved for mental health telehealth billing by both the current procedural terminology (CPT) and the Centers for Medicare Services (CMS): 99201 – 99215 – Evaluation and Management Service Codes. 90791 & 90792 – Diagnostic Interview. 90832 – Psychotherapy for 30 …

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Phone only telehealth services for Medicare during COVID-19

Details: Psychologists should bill Medicare for traditional telehealth or phone only services the same way they bill for an office visit by using the appropriate CPT ® code for the service provided. At this time, Medicare is allowing the following mental and behavioral health …

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› Url: https://www.apaservices.org/practice/clinic/covid-19-telehealth-phone-only Go Now

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CMS Releases Guidance on Telehealth Billing for RHCs

Details: CMS has established a uniform RHC telehealth payment rate of $92.00 per visit. This rate will apply to telehealth visits performed by independent or provider-based RHCs. All RHCs will bill for telehealth visits the same as you would bill for an in-person visit and use the 95 modifier on the claim line to signify that the visit was via

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Performing Annual Wellness Visits Via Telephone

Details: Billing and coding use the same CPT and ICD codes, but you should add modifier -GT to signify it was performed via telehealth. During the crisis, Medicare is reimbursing telehealth AWVs at the same rate as it would if the visit was completed in-person. Value of the Annual Wellness Visit During COVID-19

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Telehealth Billing Guidelines

Details: Telehealth Billing Guidelines . *Does not apply to crossover claims from Medicare. Provider-submitted crossover claims should be submitted with the information provided by Medicare on the explanation of benefits. appropriate U modifier indicating the type of visit.

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› Url: https://medicaid.ohio.gov/static/Providers/COVID19/Telehealth/Telehealth-Billing-Guidelines-on-or-after-11-15-2020.pdf Go Now

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Medicare "Audio-Only" Telehealth Services

Details: Medicare requires real-time, audio and visual communication for most telehealth services, such as office visits and hospital services. The April 30 revised telehealth list has a column “Can Audio-only Interaction Meet the Requirements” and some codes are indicated as “yes”. It’s old news that CMS has made major changes to its

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Telemedicine Billing Tips

Details: When billing telehealth services, healthcare providers must bill the E&M code with place of service code 02 along with a GT or 95 modifier. Telehealth services not billed with 02 will be denied by the payer. This is true for Medicare or other insurance carriers. Know how to bill a facility fee.

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COVID-19 Telemedicine - Humana

Details: During the COVID-19 public health emergency, the new waiver in Section 1135(b), opens in new window of the Social Security Act (found on the CMS Telemedicine Fact Sheet) authorizes use of telephones that have audio and video capabilities to provide Medicare telehealth services. Additionally, the Health & Human Services Office for Civil Rights (HHS OCR) will exercise enforcement discretion and

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› Url: https://www.humana.com/provider/coronavirus/telemedicine Go Now

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Answer - Coding / Billing Audio-Only Telehealth Visits

Details: CMS has stated that the telehealth codes are to be used for the visits that would normally be done in the office which this one was, but this patient did not have the internet. Telephone codes are not listed under the telehealth codes. CMS has also stated that those who …

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FAQ about Medicare Modifier For Telehealth Visit

Is telehealth covered by Medicare?

Generally speaking, Medicare Part B will cover live telehealth and telemedicine services that are comparable to office visits or consultations. Medicare specifies that they must be using a two-way telecommunications system that’s interactive and by a health care provider located elsewhere.

What is the TeleMed modifier?

The AMA introduced modifier 95 (Synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system) in 2017. Modifier 95 signifies a telehealth encounter that provides two-way, real-time audiovisual conferencing between a patient and the provider.

Which billing codes to use for telemedicine?

Commonly used office or other outpatient evaluation and management (E/M) codes for telemedicine include: 99201 – 99205 New patient visits. 99212 – 99215 Established patient visits. 99241 – 99245 Consultation codes. 99406 – 99408 Behavioral change intervention codes.