Speech-Language Pathology CPT and HCPCS Code Changes for 2021
The following additions, revisions, and deletions to Current Procedural Terminology (CPT® American Medical Association) and Healthcare Common Procedures Coding System (HCPCS) Level II codes for speech-language pathologists (SLPs) became effective January 1, 2021.
For current updates, see speech-language pathology CPT and HCPCS code changes for 2023.
New and Revised CPT and HCPCS Codes
The following new and revised CPT and HCPCS codes became effective January 1, 2021.
G-Codes for Virtual Check-Ins and Remote Video/Image Assessment
The following HCPCS G-codes were new for 2021.
G2250 Remote assessment of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related service provided within the previous 7 days nor leading to a service or procedure within the next 24 hours or soonest available appointment
G2251 Brief communication technology-based service, e.g. virtual check-in, by a qualified health care professional who cannot report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to a service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion
ASHA Notes
- Medicare created these new G-codes for use by nonphysician qualified health care professionals who can't bill evaluation and management (E/M) codes, including SLPs. For more information on virtual assessments, see Use of Communication Technology-Based Services During COVID-19.
- Current HCPCS codes G2010 and G2012 will remain for providers who can report E/M services.
- Check with state Medicaid programs and commercial insurers regarding coverage of these services.
- To correctly report, these services must be
- initiated by an established patient,
- unrelated to a previous evaluation or treatment session provided within the last seven days,
- conducted through a HIPAA-compliant platform, and
- medically necessary (requires clinical decision making and is not for administrative or scheduling purposes).
- The established patient and HIPAA requirements may be waived by some payers during the public health emergency.
- These services do not replace evaluation or treatment services described by existing CPT codes.
- Documentation of clinical decision making and storage of the exchange are required.
Nonphysician Online Digital Assessment and Management
The following CPT codes were revised effective January 1, 2021.
98970 Qualified nonphysician health care professional online digital assessment and management, for an established patient, for up to 7 days, cumulative time during the 7 days; 5-10 minutes
98971 11–20 minutes
98972 21 or more minutes
(Report 98970, 98971, 98972 once per 7-day period)
(Do not report online digital E/M services for cumulative visit time less than 5 minutes)
(Do not count 98970, 98971, 98972 time otherwise reported with other services)
ASHA Notes
- These codes, commonly known as "e-visits", are revised from "evaluation and management" to "assessment and management" services provided by nonphysician qualified health care professionals. Coding guidelines and reporting requirements have not changed.
- Medicare will allow SLPs to report these codes. Check with state Medicaid programs and commercial insurers regarding coverage for SLPs. For more information on virtual assessments, see Use of Communication Technology-Based Services During COVID-19.
- To correctly report, an online digital assessment must be
- initiated by an established patient,
- unrelated to a previous evaluation or treatment session provided within the last seven days,
- conducted through a HIPAA-compliant platform, and
- medically necessary (requires clinical decision making and is not for administrative or scheduling purposes).
- The established patient and HIPAA requirements may be waived by some payers during the public health emergency.
- These services do not represent real-time interactions and do not replace evaluation or treatment services described by existing CPT codes.
- Documentation of clinical decision making and storage of the exchange are required.
Deleted CPT and HCPCS Codes
The following CPT and HCPS codes were deleted, effective January 1, 2021.
G-Codes for Nonphysician Online Assessment and Management
G2061 Qualified non-physician healthcare professional online assessment and management, for an established patient, for up to seven days, cumulative time during the 7 days; 5–10 minutes
G2062 11–20 minutes
G2063 21 or more minutes
ASHA Notes
- These temporary HCPCS G-codes were created by Medicare to describe online "assessment and management" codes in lieu of existing "evaluation and management" codes.
- Medicare is deleting these codes and will now use CPT codes 98720-98972, since they've been revised to describe "assessment and management" services (see above).
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