Summary & Overview
HCPCS M1440: Telehealth Encounter
HCPCS Level II code M1440 designates encounters conducted via telehealth, reflecting the growing role of virtual care delivery across the U.S. health system. As telehealth becomes more integrated into ambulatory, home, and institutional care models, clear coding for remote encounters matters for claims processing, care coordination, and national tracking of telehealth utilization.
Key national payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of what M1440 covers, how payers approach telehealth encounters, and the clinical and administrative context for using the code. The publication highlights benchmarks and policy considerations relevant to telehealth billing, typical sites of service where M1440 applies, and common implementation issues that affect claim adjudication and reporting.
The intent is to provide clinicians, billing staff, and policy stakeholders with actionable reference material on the code’s definition, payer coverage landscape, and the operational context needed when documenting and submitting claims for telehealth encounters. Data not available in the input.
Billing Code Overview
HCPCS Level II code M1440 represents encounters conducted via telehealth, covering professional interactions delivered remotely using telecommunication technology. The service type is telehealth encounter and the typical site of service is remote/virtual (telehealth) — patient location and provider location connected virtually.
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Clinical & Coding Specifications
Clinical Context
A primary care patient with chronic hypertension requests a follow-up visit conducted via telehealth after recent medication adjustments. The patient is an adult established patient with stable but monitored blood pressure readings and no new red-flag symptoms. The clinical workflow begins with appointment scheduling as a telehealth encounter, verification of patient identity and consent, and reconciliation of medications and recent home blood pressure logs. The clinician (for example, a family medicine physician or nurse practitioner) documents history of present illness, reviews home vitals, adjusts medication as needed, and provides counseling. After the encounter the clinician documents time spent, clinical decisions, and next steps (labs, in‑person visit if indicated). Billing uses the HCPCS Level II code M1440 to indicate the service was rendered via telehealth in accordance with payer telehealth policies.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, separately identifiable evaluation and management service by the same physician on the same day of procedure | When a separate E/M is performed via telehealth in addition to another procedure on the same day |
95 |