Loading...

    Explore
    • Policy Monitoring
    • Live Policy Feed
    • Billing Codes
    • NPI Medicare & Medicaid
    • Healthcare Providers
    • Health Insurance Payers
    • States
    • Service Lines
    • Taxonomy Codes
    Lookup tools
    • Billing Code Lookup
    • CPT Modifier Lookup
    • Provider Taxonomy Code Lookup
    • Healthcare Provider & Facility Lookup
    • Health Insurance Payer Lookup
    • Payer Contact Directory

    Policy & Benchmark Tools

    • Prior Authorization Lookup
    • Coverage Criteria Lookup
    • Timely Filing Lookup
    • Billing Code Reimbursement Rates
    • Payer Comparison Dashboard
    • Facility Comparison Dashboard
    • All tools

    Company

    • About OpenPayer
    • Data Sources
    • Trek Health
    OpenPayerby Trek Health
    LinkedInYouTube

    © 2026 Trek Health. All rights reserved.

    OpenPayer is built and maintained by Trek Health.

    v1.0.28
    OpenPayerBilling CodesOther ServicesHCPCS hcpcs-m1443-telehealth-encounter-virtual-visit
    Ask Trek AI about this page

    HCPCS Level II M1443: Telehealth Encounter

    HCPCS Level II code M1443 represents encounters conducted via telehealth, denoting remote clinical visits delivered using telecommunication technology; the service type is telehealth visit / virtual clinical encounter, and the typical site of service is telehealth / remote patient location for evaluation and management or other covered remote services.

    For related coverage guidance, see recent payer policy updates: Interferential Stimulation Devices (for home use), Durable Medical Equipment (DME): Tumor Treating Fields (Alternating Electric Field Therapy) Medical Guideline, Durable Medical Equipment (DME): Bone Growth Stimulators Medical Guideline.

    Customize your policy alerts

    Sign up for hcpcs M1443 policy alerts

    Get alerted when payer policies referencing M1443 are released or updated.

    Monitor payer policy activity

    Receive email alerts as soon as relevant payer policies are published or updated.

    Table of contents

    Progress1 / 6

    Explore openpayer tools

    • Billing CodesCPT, HCPCS, DRG & more
    • Reimbursement RatesCommercial vs. Medicare rate reports
    • ProvidersHospitals & facilities
    • PayersPlans & market footprint
    • Taxonomy CodesNUCC specialty codes
    • ModifiersCPT modifiers & usage
    • Prior AuthorizationPA policies by payer & drug
    • Timely FilingFiling deadlines by payer
    • Coverage CriteriaMedical necessity by payer
    • Payer ContactsClaims, PA & appeals contacts
    View all tools

    Clinical & Coding Specifications

    Clinical Context

    A typical patient scenario involves an adult established primary care patient requesting a follow-up visit for management of chronic conditions via a video or audio telehealth encounter. For example, a 58-year-old patient with hypertension and type 2 diabetes who is stable but needs medication adjustment and laboratory review contacts the clinic. The medical assistant schedules a synchronous telehealth visit using a secure video platform. Before the visit, the patient completes an intake via the patient portal and uploads recent home blood pressure logs and a recent glucose meter printout. During the telehealth encounter the clinician reviews vital signs reported by the patient, reviews recent labs in the electronic health record, adjusts antihypertensive therapy, and counsels the patient on glucometer technique and medication adherence. The clinician documents time, modality (video), consent for telehealth, and medical decision-making, and then orders labs and a follow-up telehealth or in-person visit as indicated. Billing uses telehealth encounter codes such as M1443 to indicate encounters conducted via telehealth for services that are appropriate for remote delivery.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    99213Office or other outpatient visit for the evaluation and management of an established patient, typically 15 minutesCommonly used for mid-level complexity telehealth follow-up visits that mirror in-person E/M services delivered remotely.
    99446Interprofessional telephone/Internet assessment and management service provided by a consultative physician, 5-10 minutes of medical consultative discussion and reviewUsed when a clinician provides a brief interprofessional telecommunication consultation related to the patient’s care as an adjunct to the telehealth encounter.
    99421Online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time 5-10 minutesApplicable for asynchronous patient-initiated digital communications that supplement synchronous telehealth encounters.
    99091Collection and interpretation of physiologic data digitally stored and/or transmitted by the patient to the physician, requiring a minimum of 30 minutes of timePerformed when remote patient monitoring data (blood pressure, glucose) collected around the telehealth encounter require formal review and interpretation.
    99457Remote physiologic monitoring treatment management services, 20 minutes or more of clinical staff/physician/other qualified healthcare professional time in a calendar monthUsed when RPM services are provided in conjunction with telehealth management for conditions such as hypertension or diabetes.
    G2012Brief communication technology-based service, e.g., a virtual check-in, by a physician or qualified health professional who can report E/M servicesUsed for brief telephonic or digital check-ins that may precede or follow a formal telehealth encounter.

    Related Modifiers

    5 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…
    3PThe CPT Category II modifier -3P denotes a performance‑measure exclusion when a required quality action was not performed because of system‑level constraints. It is appended only to Category II…- When to apply: Use CPT Category II modifier 3P only with Category II (‘‘F’’) codes when a specific quality measure’s specifications allow a system‑level exclusion — append 3P to indicate the…
    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…
    55Modifier –55 indicates the billing provider furnished only postoperative management for a procedure that has a global surgical period. According to AAPC, this modifier is appended to the same CPT…- Use modifier -55 when billing the same CPT surgical code that has a 10- or 90-day global period and you, as a provider other than the original surgeon, furnished ONLY postoperative management (no…
    P4Modifier P4 indicates the patient is ASA Physical Status IV — a patient with severe systemic disease that is a constant threat to life. It is assigned by the anesthesia provider and must be supported…- When to apply: Use modifier P4 only on anesthesia CPT codes (00100–01999) to indicate ASA Physical Status IV — a patient with severe systemic disease that is a constant threat to life (examples:…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    207Q00000XFamily Medicine PhysicianFamily Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadt…
    208D00000XGeneral Practice PhysicianA physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
    207R00000XInternal Medicine PhysicianA physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults…
    208000000XPediatrics PhysicianA pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectru…
    364S00000XClinical Nurse SpecialistA registered nurse who, through a graduate degree program in nursing, or through a formal post-basic education program or continuing education courses…
    261QM1100XMilitary/U.S. Coast Guard Outpatient Clinic/CenterThe Defense Health Program or U.S. Coast Guard funded "fixed" facilities or distinct parts of a facility, providing outpatient medical and dental serv…
    231HA2400XAssistive Technology Practitioner AudiologistSpeech, Language and Hearing Service Providers · Audiologist
    207RH0002XHospice and Palliative Medicine (Internal Medicine) PhysicianAn internal medicine physician with special knowledge and skills to prevent and relieve the suffering experienced by patients with life-limiting illne…

    Related Payer Policy Updates

    Specialty: Durable Medical Equipment (DME)1 / 2

    5 rows

    PolicyPayerEffective Date
    Interferential Stimulation Devices (for home use)Moda Health2026-10-01
    Durable Medical Equipment (DME): Tumor Treating Fields (Alternating Electric Field Therapy) Medical GuidelineWPS Health Insurance2026-10-01
    Durable Medical Equipment (DME): Bone Growth Stimulators Medical GuidelineWPS Health Insurance2026-10-01
    General Durable Medical Equipment (DME) Medical GuidelineWPS Health Insurance2026-10-01
    Prior Authorization for Durable Medical Equipment (DME)Blue Cross Blue Shield - Rhode Island2026-10-01

    Related Codes

    HCPCS-LEVEL-II-M1252-AMBULATORY-PALLIATIVE-CARE-SURVEY-NONCOMPLETION

    HCPCS M1252: Ambulatory Palliative Care Patient Experience Survey Incomplete

    HCPCS-LEVEL-II-M1255-POSITIVE-PREGNANCY-TEST-NON-OB-VISIT

    HCPCS Level II M1255: Visit with Positive Pregnancy Test, Not Established OB

    HCPCS-LEVEL-II-M1278-ELEVATED-BLOOD-PRESSURE-WITH-DOCUMENTED-FOLLOW-UP

    HCPCS Level II M1278: Elevated or Hypertensive Blood Pressure Reading Documented

    HCPCS-LEVEL-II-M1292-FRAILTY-WITH-ADVANCED-ILLNESS-66-PLUS

    HCPCS M1292: Frailty with Advanced Illness, Age 66 and Older

    HCPCS-LEVEL-II-M1300-INFLUENZA-IMMUNIZATION-NOT-ADMINISTERED

    HCPCS Level II M1300: Influenza Immunization Not Administered, Documented Reason

    HCPCS-LEVEL-II-M1326-HYPOTONY-EVALUATION-MANAGEMENT

    HCPCS Level II M1326: Patients with a Diagnosis of Hypotony

    HCPCS-LEVEL-II-M1356-PATIENTS-WHO-DIED-DURING-MEASUREMENT-PERIOD

    HCPCS Level II M1356: Patients Who Died During Measurement Period

    HCPCS-LEVEL-II-M1375-RA-ADDITIONAL-ENCOUNTER-90-DAYS

    HCPCS Level II M1375: Additional Rheumatoid Arthritis Encounter

    HCPCS-LEVEL-II-M1384-PATIENTS-DIED-PERFORMANCE-PERIOD

    HCPCS Level II M1384: Patient Death During Performance Period

    HCPCS-LEVEL-II-M1490-PATIENT-STATUS-NOT-DOCUMENTED

    HCPCS Level II M1490: Patient Status Not Documented

    Showing 1–10 of 356

    • More pages

    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.
    Published by

    Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.