New Billing Codes Led to Explosion of Patient-Messaging Claims

  • Mar 22, 2024

    The typical cost for a patient-provider email messaging claim was $39 in 2021, including both the portion paid by health plans and by patients. Although insurers covered the full cost for 82% of these claims, the patients who need to pay out of pocket typically spent $25 on a typical email message, according to Peterson-KFF Health System Tracker.

    Use of electronic health communications has exploded since the COVID pandemic as more patients are seeking medical care remotely. CMS introduced several new billing codes in 2020 to help health care providers bill patients and insurers for a range of digital health services including electronic visits or asynchronous patient portal messages that require medical decision-making and at least five minutes of clinician time over a seven-day period.

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    © 2024 MMIT
  • Jinghong Chen

    Jinghong has been producing infographics and data stories on employer-sponsored insurance, public health insurance programs and prescription drug coverage for AIS Health’s Health Plan Weekly and Radar on Drug Benefits since 2018. She also manages AIS Health’s annual executive compensation database for top insurers and Blue Cross and Blue Shield affiliates. Before joining AIS Health, she interned at WBEZ, Al Jazeera English and The New York Times Chinese. She graduated from Missouri School of Journalism with a focus on data journalism and international reporting.

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