OpenTelemed

Telehealth National UCR Fees FY24

CPTsShort Description
National UCR FS 24 (Telehealth)
9920215 minutes E&M$186.63
9920330 minutes E&M$284.91
9920445 minutes E&M$424.65
99205MDM 60 MINUTES$559.89
99211OFFICE/OUTPATIENT EST PT MAY NOT REQ PHYS/QHP$61.31
9921210 minutes$146.06
9921320 minutes$232.61
9921430 minutes$329.08
9921540 minutes$460.72
Online Digital Visits Fee
99421ONLINE DIGITAL E/M SVC EST PT <7 D 5-10 MINUTES$37.87
99422ONLINE DIGITAL E/M SVC EST PT <7 D 11-20 MINUTES$74.83
99423ONLINE DIGITAL E/M SVC EST PT <7 D 21+ MINUTES$119.91
Non-Face-to-Face Nonphysician Telephone Services
98966NONPHYSICIAN TELEPHONE ASSESSMENT 5-10 MIN$34.26
98967NONPHYSICIAN TELEPHONE ASSESSMENT 11-20 MIN$62.21
98968NONPHYSICIAN TELEPHONE ASSESSMENT 21-30 MIN$87.46
98970QNHP OL DIGITAL ASSMT&MGMT EST PT <7 D 5-10 MIN$29.75
98971QNHP OL DIGITAL ASSMT&MGMT EST PT <7 D 11-20 MIN$53.19
98972QNHP OL DIGITAL ASSMT&MGMT EST PT <7 D 21+ MIN$81.14
98975REMOTE THERAPEUTIC MNTR 1ST SETUP&PT EDUCAJ EQP$65.08
98976REM THER MNTR DEV SUPPLY W/REC RESPIR SYS EA 30D$173.93
98977REM THER MNTR DEV SPLY W/REC MUSCSKEL SYS EA 30D$173.93
98978REM THER MNTR DEV SPLY W/REC COG BHV THER EA 30D$139.72
98980REMOTE THER MNTR TX MGMT PHYS/QHP 1ST 20 MIN$168.01
98981REMOTE THER MNTR TX MGMT PHYS/QHP EA ADDL 20 MIN$133.70
Medical nutrition therapy
97802MEDICAL NUTRITION ASSMT&IVNTJ INDIV EACH 15 MI$127.79
97803MEDICAL NUTRITION RE-ASSMT&IVNTJ INDIV EA 15 M$111.22
97804MEDICAL NUTRITION THERAPY GRP2/ INDIV EA 30 MI$57.98
Education and Training for Patient Self-Management
98960EDUCATION&TRAINING SELF-MGMT NONPHYS 1 PT$100.57
98961EDUCATION&TRAINING SELF-MGMT NONPHYS 2-4 PTS$48.51
98962EDUCATION&TRAINING SELF-MGMT NONPHYS 5-8 PTS$35.50
G2012virtual check-in , 5-10 minutes of medical discussion$36.06
G2010Remote evaluation of recorded video and/or images submitted by an established patient (e.g., store and forward)$31.56
Remote Patient Monitoring
99453REM MNTR PHYSIOL PARAM 1ST SET UP PT EDUCAJ EQP$65.08
99454REM MNTR PHYSIOL PARAM 1ST DEV SUPPLY EA 30 D$173.93
99457REMOTE PHYSIOLOGIC MONITORING 1ST 20 MIN MONTH$165.65
99458REMOTE PHYSIOLOGIC MONITORING EA ADDL 20 MIN MO$133.70
99091COLLJ & INTERPJ PHYSIOL DATA MIN 30 MIN EA 30 D$179.85
Self Measured Blood Pressure
99473SELF-MEAS BP PT EDUCAJ/TRAING & DEV CALIBRATION$43.78
99474SELF-MEAS BP 2 READG 1 MIN APART BID 30 DAY PD$52.06
Telephone E&M
99441PHYS/QHP TELEPHONE EVALUATION 5-10 MIN$146.06
99442PHYS/QHP TELEPHONE EVALUATION 11-20 MIN$232.61
99443PHYS/QHP TELEPHONE EVALUATION 21-30 MIN$329.08
Interprofessional Phone/internet/EHR Assmt & Mgmt service, including a verbal and written report
99446NTRPROF PHONE/NTRNET/EHR ASSMT&MGMT 5-10 MIN$44.18
99447NTRPROF PHONE/NTRNET/EHR ASSMT&MGMT 11-20 MIN$89.26
99448NTRPROF PHONE/NTRNET/EHR ASSMT&MGMT 21-30 MIN$135.24
99449NTRPROF PHONE/NTRNET/EHR ASSMT&MGMT 31/> MIN$181.22
Radiology Services
72010 – 73050Professional Component (Modifier 26), X-rays20% of UCR ($50 – $500)
95782 – 95811Professional Component (Modifier 26), Polysomnography$243.36 – $715.83
Ultrasound services
Doppler Echocardiography
93325Doppler echocardiography color flow velocity mapping (when performed with echocardiography). Professional Component (Modifier 26)$46.95
Pulmonary/Lung Ultrasound
76604Professional Component (Modifier 26), Ultrasound, chest (includes mediastinum), real time with image documentation$50.84
Obstetrics Ultrasound
76801Professional Component (Modifier 26), Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation$93.10
76802Professional Component (Modifier 26), each additional gestation (List separately in addition to code for primary procedure)$78.40
76805Professional Component (Modifier 26), Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> 14 weeks 0 days), transabdominal approach; single or first gestation$93.77
76810Professional Component (Modifier 26), each additional gestation (List separately in addition to code for primary procedure)$92.60
76811Professional Component (Modifier 26), Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation$179.16
76812Professional Component (Modifier 26), …each additional gestation (List separately in addition to code for primary procedure)$168.40
76815Professional Component (Modifier 26), Ultrasound, pregnant uterus, real time with image documentation, limited (e.g., fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), one or more fetuses$60.92
76816Professional Component (Modifier 26), Ultrasound, pregnant uterus, real time with image documentation, follow-up (e.g., re-evaluation of fetal size by measuring standard growth parameters and/or amniotic fluid volume, second or third trimester), single or first gestation, each additional gestation (List separately in addition to code for primary procedure)$80.50
76817Professional Component (Modifier 26), Ultrasound, pregnant uterus, real time with image documentation, transvaginal$71.00
Musculoskeletal Ultrasound
76881Professional Component (Modifier 26), Ultrasound, extremity, non-vascular, real time with image documentation; complete$85.71
76882Professional Component (Modifier 26), Ultrasound, extremity, non-vascular, real time with image documentation; limited, anatomic specific$64.87
Other Ultrasound Procedures
76700Professional Component (Modifier 26), Ultrasound, abdominal, real time with image documentation; complete$75.63
76705Professional Component (Modifier 26), Ultrasound, abdominal, real time with image documentation; limited$54.87
76770Professional Component (Modifier 26), Ultrasound, retroperitoneal (e.g., renal, aorta, nodes), real time with image documentation; complete$69.57
76775Professional Component (Modifier 26), Ultrasound, retroperitoneal (e.g., renal, aorta, nodes), real time with image documentation; limited$54.20
76776Professional Component (Modifier 26), Ultrasound, transplanted kidney, real time and duplex Doppler with image documentation$70.92
76937Professional Component (Modifier 26), Ultrasound guidance for vascular access requiring ultrasound evaluation of potential access sites, documentation of selected vessel patency, concurrent real-time ultrasound visualization of vascular needle entry, with permanent recording and reporting$27.31
76942Professional Component (Modifier 26), Ultrasonic guidance for needle placement (e.g., biopsy, aspiration, injection, localization device), imaging supervision and interpretation$59.59
Pathology tests
80047-80081Professional Component (Modifier 26), Organ or Disease-Oriented PanelsT.B.O FY 24
80150-80299Professional Component (Modifier 26), Drug TestingT.B.O FY 24
80305-80377Professional Component (Modifier 26), Therapeutic Drug AssaysT.B.O FY 24
80400-80440Professional Component (Modifier 26), Endocrinology TestingT.B.O FY 24
80500-80502Professional Component (Modifier 26), Clinical Pathology ConsultationsT.B.O FY 24
81000-81099Professional Component (Modifier 26), UrinalysisT.B.O FY 24
81105-81383Professional Component (Modifier 26), Molecular PathologyT.B.O FY 24
81400-81479Professional Component (Modifier 26), Genetic TestingT.B.O FY 24
81500-81599Professional Component (Modifier 26), Multianalyte Assays with Algorithmic AnalysesT.B.O FY 24
82000-84999Professional Component (Modifier 26), Chemistry TestsT.B.O FY 24
85002-85999Professional Component (Modifier 26), Hematology and CoagulationT.B.O FY 24
86000-86849Professional Component (Modifier 26), ImmunologyT.B.O FY 24
86850-86999Professional Component (Modifier 26), Transfusion MedicineT.B.O FY 24
87001-87999Professional Component (Modifier 26), MicrobiologyT.B.O FY 24
88000-88099Professional Component (Modifier 26), Anatomic PathologyT.B.O FY 24
88104-88199Professional Component (Modifier 26), CytopathologyT.B.O FY 24
88230-88299Professional Component (Modifier 26), Cytogenetic StudiesT.B.O FY 24
88300-88399Professional Component (Modifier 26), Surgical PathologyT.B.O FY 24
88720-88749Professional Component (Modifier 26), In Vivo Lab ProceduresT.B.O FY 24
89049-89240Professional Component (Modifier 26), Other ProceduresT.B.O FY 24
89250-89398Professional Component (Modifier 26), Reproductive Medicine ProceduresT.B.O FY 24
74420Urography, retrograde, with or without KUB Professional Component (Modifier 26)$156.75
****At OpenTelemed, our fee schedules are aligned with the National UCR 24 benchmarks. However, please note that variations may occur based on specific state regulations and the applicable UCR. We encourage you to request detailed information regarding your UCR and insurance guidelines following your agreement with us. This will ensure that you have a clear understanding of your competitive fees and expected compensation. Additionally, should you find that certain procedures or modalities are not listed in our initial fee schedule, we are more than willing to accommodate your needs and can add these services upon request.