What are the Interprofessional Telephone/Internet Consultation codes?

The CMS 2019 final code descriptors are as follows:

CPT 99446: Interprofessional telephone/Internet assessment and management service provided by a consultative physician including a verbal and written report to the patient's treating/requesting physician or other qualified health care professional; 5-10 minutes of medical consultative discussion and review

CPT 99447: Same service as 99446, but 11-20 minutes of medical consultative discussion and review

CPT 99448: Same service as 99446, but 21-30 minutes of medical consultative discussion and review

CPT 99449: Same service as 99446, but 31 minutes or more of medical consultative discussion and review

CPT 99451: Interprofessional telephone/Internet/electronic health record assessment and management service provided by a consultative physician including a written report to the patient’s treating/requesting physician or other qualified health care professional, 5 or more minutes of medical consultative time

CPT 99452: Interprofessional telephone/Internet/electronic health record referral service(s) provided by a treating/requesting physician or qualified health care professional, 30 minutes of preparatory time and active engagement time with the consultant. 


What are the qualifying criteria for Interprofessional Internet Consultations?

Since January 1, 2019, physicians and other Qualified Healthcare Providers (QHCPs) who can independently bill for E/M services can obtain stand-alone reimbursement for IICs according to the following criteria:

  1. Billing Practitioner: Billing for interprofessional services is limited to those practitioners that can independently bill Medicare for E/M services. CPT Code 99452 applies to the treating/referring physician or QHCP, and the rest of the codes apply to the consultative physician or QHCP. 

  2. Consent. Verbal patient consent must be documented in the patient’s medical record for each consultation. The patient’s consent must include assurance that the patient is aware of applicable cost-sharing.

  3. Cost Sharing. Providers must collect the requisite copayment from the patient for each service billed, as with all Medicare Part B services.

  4. Benefit of the Patient. The consultation must be undertaken for the benefit of the patient. Because the patient is going to be responsible for cost-sharing, CMS wants to distinguish these Interprofessional Internet Consultations from those undertaken for the edification of the practitioner, such as information shared as a professional courtesy or as continuing education.

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