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    v1.0.31
    OpenPayerBilling CodesProcedures / Professional ServicesHCPCS hcpcs-g0427-telehealth-consultation-emergency-inpatient-70min
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    HCPCS G0427: Telehealth Consultation, ED or Initial Inpatient

    HCPCS Level II code G0427 describes a telehealth consultation provided in the emergency department or as an initial inpatient consultation, typically involving 70 minutes or more of synchronous communication with the patient via telehealth; the service type is telehealth consultation and the typical site of service is the emergency department or inpatient hospital setting.

    For related coverage guidance, see recent payer policy updates: Achalasia and Gastroesophageal Reflux Disease (GERD) - Minimally Invasive Procedures - Medical Policy, Esophageal Brush Biopsy, Percutaneous Electrical Nerve Field Stimulation for Functional Abdominal Pain Disorders.

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    Clinical & Coding Specifications

    Clinical Context

    A typical patient scenario involves an adult presenting to the emergency department with acute chest pain and shortness of breath. The emergency department physician determines that the patient requires an extended, complex telehealth consultation because in-person specialty input is needed, the patient is isolated for infection control, or the treating clinician is consulting an inpatient tele-neurology or tele-cardiology specialist. The telehealth consultation is provided via an interactive audio-video connection and lasts 70 minutes or more, involving review of history, extensive review of imaging and monitors, real-time discussion with the patient and family, coordination with bedside staff, and formulation of an admission and management plan.

    Clinical workflow:

    • The emergency or admitting clinician documents the reason for the telehealth consult and requests a remote specialist.

    • The telehealth specialist connects via secure interactive video, confirms patient identity, obtains history, reviews pertinent records and imaging with bedside staff, and performs a virtual exam as feasible.

    • The specialist documents start and stop times to verify the 70+ minute duration, documents medical decision-making, recommendations, and communications with the treating team and family.

    • Billing staff assign G0427 for a telehealth consultation in the ED or initial inpatient setting when the documented interactive time meets or exceeds 70 minutes and attach appropriate modifiers to reflect circumstances (for example, telehealth modality or multiple concurrent care).

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    99221Initial hospital inpatient care, typically 30 minutes on the date of inpatient admissionPerformed by admitting hospitalist; may occur before or in conjunction with the telehealth consultation when in-person admission examination is completed.
    99285Emergency department visit for the evaluation and management of a patient, high complexityThe ED treating clinician documents the initial visit; G0427 is a separate telehealth specialist consult that supplements the ED E/M when required.
    99446Interprofessional telephone/Internet assessment and management service, 5-10 minutes of medical consultative discussion and reviewShorter interprofessional consults are alternatives; G0427 represents a much longer, direct telehealth consult (70+ minutes) typically involving direct patient interaction.
    99451Interprofessional telephone/Internet consultative service provided by a physician, 5 minutes or more of medical consultative time, without the patient presentUsed for physician-to-physician consults; contrasts with G0427 which is a direct patient telehealth consultation.
    96372

    Related Modifiers

    7 rows

    ModifierDescriptionWhen to Use
    95Modifier 95 indicates that a service was provided via synchronous, real‑time audio‑video telehealth rather than in‑person. Per CMS, AAPC and professional associations, append modifier 95 to claim…- Use modifier 95 to indicate a service was furnished via synchronous, real‑time audiovisual telehealth (a live audio‑video conference between patient and provider) rather than in‑person. - Pair…
    25CPT modifier 25 indicates that on the same day as another procedure or service, the same physician or other qualified health care professional provided a significant, separately identifiable…- When to apply: Use modifier 25 only on an E/M code to indicate the same provider delivered a significant, separately identifiable E/M service on the same day as another procedure or service — i.e.,…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    208000000X
    207R00000X
    207RC0000X
    207N00000X
    2084P0800X
    146N00000X
    261QA0900X
    2278E1000X

    Related Payer Policy Updates

    Specialty: Gastroenterology1 / 3

    10 rows

    PolicyPayerEffective Date
    Achalasia and Gastroesophageal Reflux Disease (GERD) - Minimally Invasive Procedures - Medical PolicyHealth-New-England2027-02-01
    Esophageal Brush Biopsycaresourcegeorgia2026-12-01
    Percutaneous Electrical Nerve Field Stimulation for Functional Abdominal Pain Disordersbcbsvermont2026-12-01
    Gastric Pacing/Gastric Electrical Stimulation (GES)Cigna2026-11-15
    Percutaneous Electrical Nerve Field Stimulation for Disorders of Gut-Brain Interactionpremerabluecrossofwashington2026-11-06
    Percutaneous electrical nerve field stimulation for disorders of gut-brain interactionpremerabluecrossofwashington2026-11-06
    Percutaneous Electrical Nerve Field Stimulation for Disorders of Gut-Brain Interactionpremerabluecrossofwashington2026-11-06
    Esophagogastroduodenoscopy (EGD) Coverage Policyevicore2026-11-05
    Non-invasive Testing for Liver FibrosisModa Health2026-11-01
    Surgical Site of Care - Colonoscopy and Sigmoidoscopyregence2026-11-01

    Related Codes

    HCPCS-G9490-HOME-ASSESSMENT-NON-HOMEBOUND

    HCPCS G9490: Home Visit Patient Assessment for Non-Homebound Beneficiary

    HCPCS-G0008-INFLUENZA-VACCINE-ADMINISTRATION

    HCPCS G0008: Administration of Influenza Virus Vaccine

    HCPCS-G0009-PNEUMOCOCCAL-VACCINE-ADMINISTRATION

    HCPCS G0009: Administration of Pneumococcal Vaccine

    HCPCS-G0010-HEPATITIS-B-VACCINE-ADMINISTRATION

    HCPCS G0010: Administration of Hepatitis B Vaccine

    HCPCS-G0011-PREP-COUNSELING-HIV-RISK-REDUCTION-ADHERENCE

    HCPCS G0011: Individual PrEP Counseling, HIV Risk Assessment

    HCPCS-G0012-PRE-EXPOSURE-PROPHYLAXIS-INJECTION-HIV-PREVENTION

    HCPCS G0012: Injection of PrEP Drug for HIV Prevention

    HCPCS-G0013-PREP-INDIVIDUAL-COUNSELING-HIV-RISK-REDUCTION

    HCPCS G0013: Individual PrEP Counseling by Clinical Staff

    HCPCS-G0017-PSYCHOTHERAPY-CRISIS-FIRST-60-MINUTES-NON-OFFICE

    HCPCS G0017: Psychotherapy for Crisis, First 60 Minutes

    HCPCS-G0018-PSYCHOTHERAPY-CRISIS-ADDITIONAL-30-MINUTES-NON-OFFICE

    HCPCS G0018: Psychotherapy for Crisis, Additional 30 Minutes

    HCPCS-G0019-COMMUNITY-HEALTH-INTEGRATION-SDOH-CARE-COORDINATION

    HCPCS G0019: Community Health Integration, Person-Centered Assessment

    Showing 1–10 of 1996

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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    Therapeutic, prophylactic, or diagnostic injection (subcutaneous or intramuscular)
    Procedural treatments ordered during or after the telehealth consult may be performed in-person by bedside staff; this CPT documents those interventions.