Summary & Overview

HCPCS G2250: Remote Assessment of Video/Images with Timely Follow-Up

HCPCS Level II code G2250 designates an asynchronous remote assessment of recorded video or images submitted by an established patient, including clinician interpretation and follow-up within 24 business hours. This code captures a growing category of store-and-forward telehealth services that allow clinicians to evaluate visual information without a synchronous visit. Nationally, G2250 matters because it expands billing clarity for non-real-time telemedicine workflows, supporting access, triage, and care management while preserving limits to avoid duplicative services around recent or imminent in-person care.

Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find concise benchmarks for coverage and payment patterns from major payers, summaries of relevant policy updates affecting asynchronous telehealth billing, and clinical context describing typical use cases and appropriate service settings. The publication also outlines common modifiers associated with billing practice and highlights documentation and timing conditions embedded in the code definition.

This resource is written for clinicians, billing professionals, and policy analysts seeking a national overview of G2250—what the code represents, where it fits in telehealth service lines, and the payer and policy considerations that influence adoption and reimbursement.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareG2250HCPCS Level IItelehealthstore-and-forwardasynchronous assessmentremote patient monitoringmedical billingvirtual care

Billing Code Overview

HCPCS Level II code G2250 describes a remote assessment of recorded video and/or images submitted by an established patient (commonly known as store-and-forward telemedicine). The service includes interpretation of the submitted media and follow-up with the patient within 24 business hours, provided the assessment did not originate from a related service in the prior seven days and does not lead to a service or procedure within the next 24 hours or the soonest available appointment.

Service type: Asynchronous (store-and-forward) telehealth assessment with clinician interpretation and timely follow-up.

Typical site of service: Remote or virtual — not tied to an in-person facility; the clinician may perform the assessment from an office, clinic, or other remote location while the patient submits media from another location.

Clinical & Coding Specifications

Clinical Context

A 45-year-old established patient with a history of recurrent acne submits a secure smartphone photograph of a new inflammatory lesion on the cheek via the practice’s patient portal. The dermatologist reviews the stored image and accompanying brief history, documents findings, and provides an assessment and management plan by secure message within 24 business hours. No related office visit or procedure occurred in the prior 7 days, and the clinician’s assessment does not lead to an in-person procedure within the next 24 hours or the soonest available appointment. The workflow includes intake (patient uploads image and brief history), clinician review of the recorded image and chart, documentation of interpretation and plan, and follow-up communication with the patient (prescription change, self-care instructions, or advice to schedule an appointment if symptoms worsen). Typical sites of service are outpatient clinic-based telehealth platforms or clinician offices using store-and-forward systems; this service is billed for asynchronous remote evaluation of images or video from an established patient when the criteria in G2250 are met.

Coding Specifications

Modifier	Description	When to Use
`11`	Normal or standard procedural service	Use when the service is furnished as a routine service without unusual procedural circumstances.
`22`	Increased procedural services	Use when documentation supports substantially greater service than typical for the code.
`23`	Unusual anesthesia	Use if unusual anesthesia is provided related to a linked procedure (rare for `G2250`).
`52`	Reduced services	Use when the service provided is partially reduced or discontinued.
`53`	Discontinued procedure	Use when the service was started but stopped for patient safety or other valid reason.
`59`	Distinct procedural service (Note: not in provided list)	Data not available in the input.
`62`	Two surgeons	Use when two surgeons are required for a related procedure (unlikely for pure remote assessment).
`78`	Return to OR for related procedure following initial procedure	Use when a subsequent operative procedure is required after a prior operation (not typical for `G2250`).
`80`	Assistant surgeon	Use when an assistant surgeon is involved in a related procedure.
`82`	Assistant surgeon (when qualified resident unavailable)	Use when a qualified resident is unavailable for a related procedure.
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery	Use when applicable to related operative services.
`CO`	Catastrophe/disaster-related	Use when service is related to a declared disaster.
`CQ`	Service furnished by a physical therapist in alternative payment demonstration	Use only in specified demonstration programs.
`QK`	Medical direction of two, three, or four concurrent anesthesia procedures	Use for anesthesia-related billing, not typically applicable to `G2250`.
`QX`	CRNA service: with medical direction by a physician	Use for anesthesia services.

Associated Provider Taxonomies

Taxonomy Code	Specialty	Notes
`207N00000X`	Dermatology	Dermatologists commonly interpret skin images and manage follow-up remotely.
`207Q00000X`	Family Medicine	Primary care clinicians frequently perform remote image assessments for common conditions.
`207R00000X`	Internal Medicine	Internists may provide store-and-forward assessments for chronic condition follow-up.
`208D00000X`	Pediatrics	Pediatricians may evaluate parent-submitted images for pediatric dermatologic or injury concerns.
`363A00000X`	Nurse Practitioner	Nurse practitioners provide asynchronous image review and follow-up within their scope.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`L70.0`	Acne vulgaris	Common dermatologic reason for patient-submitted photos for remote assessment and management.
`L98.0`	Localized (atypical) skin reaction	Useful for differentiating inflammatory or contact-related lesions from infection.
`S00.83XA`	Superficial injury of other part of head, initial encounter	Patient-submitted images often used to triage minor trauma or abrasions.
`L03.90`	Cellulitis, unspecified	Remote image review can identify suspected cellulitis and prompt escalation.
`L29.9`	Pruritus, unspecified	Photos help evaluate excoriations or rashes associated with itch.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`99421`	Online digital evaluation and management service, for an established patient, 5-10 minutes of medical consultative discussion and review	May be used for synchronous or asynchronous digital E/M communication when time-based E/M is documented and meets payer criteria; complements `G2250` when additional text-based management occurs.
`99422`	Online digital E/M service, established patient, 11-20 minutes	Higher time increment for more complex digital management following image review.
`99423`	Online digital E/M service, established patient, 21+ minutes	Use when substantial time is spent in digital evaluation beyond typical `G2250` interpretation and brief follow-up.
`99091`	Collection and interpretation of physiologic data digitally stored and/or transmitted by the patient, requiring 30 minutes of clinical staff/physician time	May be billed when extensive data review accompanies image-based assessment and meets criteria.
`99072`	Additional supplies, materials and clinical staff time over and above those usually included with the visit, when performed during a public health emergency	Use only in specified emergency situations when extra resources are required in relation to remote services.