If your doctors spend hours every week answering complex medical questions via the secure patient portal (MyChart, etc.), you should be billing "E-Visits" using CPT 99421-99423.
Cumulative Time Over 7 Days
Unlike standard E/M codes, E-Visits are billed based on the cumulative time spent responding to the patient over a 7-day period.
- 99421: 5-10 minutes
- 99422: 11-20 minutes
- 99423: 21 or more minutes
Medical Necessity & Patient Initiation
The E-Visit must be initiated by the patient (they messaged you first). It must involve true medical evaluation and management, not just scheduling a refill or answering a quick administrative question.
NCCI Edits
Like all digital/telehealth codes, if the portal message results in an in-person visit within 24 hours or the soonest available appointment, the time spent messaging is bundled into the in-person E/M visit.