Table 1: Distinguishing the Codes
| CPT Code | Reported by | Conclusion | Time required | How time is spent | 2021 w/RVUs | 2021 RVUs | 2021 PFS (national avg.) |
| 99446 | Consultant | Verbal and written report to requestor | 5–10 minutes | Review pertinent medical records, lab images, medication profile, etc. and medical consultative verbal or internet discussions | 0.35 | 0.54 | $18.84 |
| 99447 | Consultant | Verbal and written report to requestor | 11–20 minutes | Review pertinent medical records, lab images, medication profile, etc. and medical consultative verbal or internet discussions | 0.70 | 0.97 | $33.85 |
| 99448 | Consultant | Verbal and written report to requestor | 21–30 minutes | Review pertinent medical records, lab images, medication profile, etc. and medical consultative verbal or internet discussions | 1.05 | 1.54 | $53.74 |
| 99449 | Consultant | Verbal and written report to requestor | ≥31 minutes | Review pertinent medical records, lab images, medication profile, etc. and medical consultative verbal or internet discussions | 1.40 | 2.10 | $73.28 |
| 99451 | Consultant | Verbal and written report to requestor | ≥5 minutes | Review pertinent medical records, lab images, medication profile, etc. and medical consultative verbal or internet discussions | 0.70 | 1.04 | $36.29 |
| 99452 | Treating/ requesting physician/ QHP |
N/A | 16–30 minutes | Preparing for the consult and/or the actual time spent communicating with the consultant | 0.70 | 1.05 | $36.64 |
According to the CPT, the majority of the service time reported (greater than 50%) must be devoted to the medical consultative verbal or internet discussion. If greater than 50% of the time for the service is devoted to data review and/or analysis, 99446, 99447, 99448 and 99449 should not be reported. However, the service time for 99451 is based on total review and interprofessional communication time. Additionally, telephone or internet consults of fewer than five minutes should not be reported.
Consultant communications with the patient and/or family may be reported using 99441, 99442, 99443, 99444, 98966, 98967, 98968 or 98969, and the time related to these services is not used in reporting interprofessional telephone or internet consult codes 99446, 99447, 99448 or 99449.
Finally, the written or verbal request for telephone or internet/electronic health record advice by the treating/requesting physician or QHP, including the reason for the request, should be documented in the patient’s medical record.
For additional questions on the interprofessional telephone consultation codes or training on CPT coding and billing, contact the ACR practice management team at [email protected].
Prolonged Codes Survey
The ACR prolonged codes survey is in progress. If you were randomly selected to participate, we urge you to take this opportunity to complete the survey as we work with the AMA to ensure relative values will be accurately and fairly presented to the Relative Value Update Committee (RUC) during their review process.
