CPT® Code 98972

Nonphysician qualified health care professional online digital assessment and management, for an established patient, for up to 7 days, cumulative time during the 7 days; 21 or more minutes

The CPT® Code 98972 refers to a specific type of online digital assessment and management service provided by a nonphysician qualified health care professional for an established patient. This service is characterized by a cumulative time of 21 or more minutes spent over a period of up to 7 days. The encounter is initiated by the patient through electronic communication methods such as email, an electronic health record (EHR) portal, or similar digital platforms. During this interaction, the qualified health care professional, which may include registered dieticians, physical therapists, occupational therapists, or speech-language pathologists, engages in a comprehensive evaluation of the patient's concerns and inquiries. The process involves reviewing the patient's initial communication, addressing their complaints, and answering any questions they may have. The professional also examines the patient's medical records and other relevant data, requests additional information if necessary, and may collaborate with clinical staff regarding the patient's issues. Based on this assessment, the qualified professional develops a management or treatment plan, which may include writing prescriptions or ordering tests, as well as providing counseling and instructions to the patient. All interactions and decisions made during this digital service are documented and stored in the patient's medical record. It is important to note that the digital encounter must begin with a review of a new inquiry that is not related to any postoperative or previous assessment and management service conducted within the last seven days. The time spent on the digital service is cumulative and is reported according to the specific time intervals outlined in the CPT® coding guidelines.