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Coverage of interprofessional internet consultation for Medicare Advantage members

October 8, 2019

As of January 1, 2019, the Centers for Medicare & Medicaid Services (CMS) updated their benefit coverage position for interprofessional internet consultation services from not covered to covered. This change in benefit coverage position applies to our Medicare Advantage members and is retroactively effective January 1, 2019.

Independence covers interprofessional internet consultation services for our Medicare Advantage members but considers these services to be an integral part of other services for which we provide coverage. Therefore, interprofessional internet consultation services with the below CPT® procedure codes are not eligible for separate reimbursement consideration, whether billed alone or in conjunction with other covered services.

  • 99446
  • 99447
  • 99448
  • 99449
  • 99451
  • 99452

Participating providers may not separately bill members for interprofessional internet consultation services.

An interprofessional internet consultation is an assessment and management service in which an individual’s treating professional provider requests the opinion and/or treatment advice of a consultant. The consultant has specialty expertise to assist the treating professional provider in the diagnosis and/or management of the individual’s problem without the need for the individual’s presence.

Learn more

For more information about interprofessional internet consultation services for our Medicare Advantage members, please refer to the news article Coverage of Interprofessional Internet Consultation, which was posted to our Medical Policy Portal on September 12, 2019, and is retroactively effective January 1, 2019.

To view the news article, visit the News & Announcements section of our Medical Policy Portal.

CPT Copyright 2017 American Medical Association. All Rights Reserved. CPT® is a registered trademark of the American Medical Association.


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