Background: Digital tools are increasing access to healthcare. It is now easier to message a practitioner through a secure portal to request refills or labs and follow up on some appointments. In many cases, the necessary and appropriate services can be performed without an appointment. Portal Visit codes released in 2022 made it possible for healthcare providers to be compensated for some of the work they perform between appointments.
Portal Visit: A portal visit is a digital communication initiated by the patient through the secure patient portal. It is a series of back-and-forth messages between the patient and the practitioner. It does not involve a specific meeting time, speaking on the phone or over video. This visit type is a good option when the patient has a non-urgent concern/question/request that does not involve a lot of additional history-taking or a physical exam. There will be times that the practitioner determines that a Portal Visit is inappropriate for the concern at hand and needs to be converted to an in-person or Telemedicine encounter.
Codes: The allowable costs are much lower than those associated with an appointment and represent excellent value for professional medical services. But in most cases, deductibles and copays will apply – meaning that the insurance companies will be able to deflect much or even all of the cost back to the patient. The portal visit code is based on the cumulative time the practitioner devotes to the back-and-forth messages including records review, documentation and evaluation and management. A Portal Visit will not be billed if a patient has been seen in the last 7 days and is following up on a concern already reviewed during a visit. If the issue is new, a portal visit may be billed. While most requests are completed in 5-10 minutes, there are 3 different billing levels which are described below. Please refer to the Fees Page for the most up to date approximations of the cost of each service code.
- 99421: 5-10 minutes
- 99422: 11-20 minutes
- 99423: 21-30 minutes