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Update to Controlling High Blood Pressure Measure for Care Delivered in 2020

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The Alliance is happy to share a positive update about the remote monitoring of blood pressure. The National Committee for Quality Assurance (NCQA) recently released new code sets for measurement year 2020, giving the capability of remote monitoring a boost! You may be aware, Controlling High Blood Pressure (CBP) is a measure in our annual Healthcare Effectiveness Data and Information Set (HEDIS) Compliance Audit. Newly approved methodology and code sets (below) promote continuity of care by utilizing telehealth (telephone, virtual, and online assessment tools) to monitor your hypertensive patient’s blood pressure when submitted with the CPT Category II code values. We at the Alliance hope that these newly approved methods help keep your staff and patients as healthy and safe as possible.

BP Value CPT-CAT-II Code
Systolic Less Than 140 3074F, 3075F
Systolic Greater Than or Equal To 140 3077F
Diastolic Less Than 80 3078F
Diastolic 80–89 3079F
Diastolic Greater Than or Equal To 90 3080F

 

Type of Visit HCPCS
Telephone & Virtual Video Visits Use synchronous telehealth modifier and POS code as applicable with PCP office codes (table below)
Telemedicine Specific Codes G2010 Remote Evaluation 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 E/M Service Provided
G2012 Brief Communication Technology-Based Service, E.G. Virtual Check-In, By A Physician or Other Qualified Health Care Professional Who Can Report Evaluation and Management Services, Provided to An Established Patient, Not Originating from A Related E/M
Must bill either G code with telehealth modifiers 95 or GT

Any clinician eligible to bill for office visits may conduct a telephone or video visit with a patient in lieu of an office visit by way of a HIPAA compliant platform that supports provider to patient communication for patient care. The CPT or HCPC code(s) must be billed using:

MODIFIER and POS
Synchronous telehealth, interactive audio and telecommunications system 95
Asynchronous telehealth, store and forward telecommunications system GQ
POS (Place of service for non FQHCs) 02

Previous telehealth guidelines available through the Provider News: https://www.ccah-alliance.org/providerspdfs/Provider_Memos/2020/03252020_Guidance_on_Telehealth_Services.pdf

If you have any questions, please contact the QI Department at [email protected]