telemedicine reimbursement

Asynchronous telemedicine is covered by insurance

Over 10,000 asynchronous telehealth visits have been successfully billed to insurance by doctors who use HealthLens.

Most states have telehealth parity laws that mandate private-payer reimbursement for “store-and-forward” telemedicine to be the same as an office visit.

Other states have issued special waivers during COVID that permit healthcare providers to use any telehealth modality that is appropriate and require insurance carriers to cover telehealth services in any case where the same in–person service would be covered.

Private Payers

  • All the large commercial private payers (Blue Cross, Blue Shield, Aetna, Cigna, & United Healthcare) cover telemedicine visits billed with the GQ modifier, which denotes asynchronous telemedicine was used
  • The most common CPT codes used for visits on HealthLens are 99203 GQ, 99213 GQ, 99343 GQ, and 99349 GQ


  • Medicare now reimburses for telephone-only codes 99421 & 99441 at the same rate as an office visit – No live-video is required!
  • Medicare requires the 95 modifier in order to bill for a telehealth visits with an office visit code, which necessitates a video call

Telemedicine reimbursement during COVID-19

On April 1st, 2020, CMS added home visit codes 99343 & 99349 to their List of Telehealth Services. Unlike most telemedicine platforms, patient encounters on HealthLens meet CMS’ criteria for home visit codes.

This is great news for physicians who use HealthLens because reimbursement for home visit codes is typically 60 – 70% more than office visit codes 99201 – 99214.

To learn more about your state’s current telemedicine laws & reimbursements policies, please click here: Current State Laws & Reimbursement Policies.

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