Modifier 93: Synchronous Telemedicine Service Rendered Via Telephone or Other Real-Time Interactive Audio-Only Telecommunications System was accepted at the September 2021 CPT Editorial Panel meeting. It is used to describe real-time telemedicine services rendered via audio only.
Synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located at a site distant from that provider. The totality of the information exchanged between the physician or other qualified healthcare professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction.
It is important to note that further CPT Editorial Panel or Executive Committee actions may affect these codes and/or descriptors. For this reason, code numbers and/or descriptor language in the CPT code set may differ at the time of publication. For example, modifier 93 went into effect Jan. 1, 2022, but will not be published in the CPT manual until 2023.
No Surprise Billing Act
Congress passed the No Surprises Act, which creates protections for patients by banning surprise medical bills under certain circumstances beginning Jan. 1, 2022. Surprise medical billing, or balance billing, results when patients receive care from out-of-network providers or facilities and the service costs are not fully covered by the patient’s insurance provider. New protections regulate certain provider balance billing and create new pathways for patients to better understand the cost of services.
The ACR advocacy team continues to monitor the impact of the No Surprises Act and will report additional information that will impact rheumatology practices. More information is also available from the AMA in a physician toolkit related to the act’s implementation.
The ACR practice management department is working to provide the appropriate training for rheumatologists and their staff to be ready for upcoming changes. The first coding and billing training for 2022 will take place virtually during the ACR Education Exchange on April 29. For questions or information on training, contact the ACR practice management department at [email protected].
