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A Surefire Way to Increase Practice Income and Reduce Overhead in 2022

Inga C. Ellzey, RHIA, MPA, CDC

By February 9, 2022April 20th, 2023No Comments

Hello 2022 and hello new age of medicine! If you’re experiencing staffing shortages, Covid issues, weather problems, or an increase in no-shows then keep reading.

If you want to know about a no-risk, easy-to-implement way to solve your practice problems this year, I have the answer for you.


This is probably one of the, if not the, best options as far as increasing patient volume thereby increasing profits and decreasing overhead.  Integrating Telemedicine as an option for patient care has been made so much easier to implement since the adaptation of new COVID protocols.

Let’s start with the good part; what will you get paid?

Is it worth it?  Yes it is!  The required CPT codes are all based on time.  That makes it easy for you to figure out as how much time you spend as your device or system will track exactly how many minutes are spent with each patient.

CodeTime SpentReimbursement
994415-10 minutes$74.65*
9944211-20 minutes$120.45*
9944321-30 minutes$170.44*

*Amounts vary slightly by state or insurance carrier

How does it work?  

First, Telemedicine services can only be delivered to established patients. Then you chose what types of skin conditions you are comfortable seeing via Telemedicine.  Here are some examples:

Skin rashes, infections, itchy skin, scalp or other scalp conditions, skin lesions, eczema, psoriasis, warts, different types of acne, skin checks for lesions, cancer concerns, hair loss, and nail fungus and other nail conditions, just to name a few.

Converting in-office visits to Telemedicine. 

Previously many of the below services were done for free.  Now, these types of visits can be billed and will generate income.  Common services where Telemedicine, initiated by the provider, can easily be used:

  1. Follow-up visits for the previously listed skin conditions
  2. Discussion of pathology and lab results
  3. Patient refills or medication changes
  4. Management of chronic conditions
  5. Discussion of planned surgery
  6. Consultations from other providers

The Place of Service code has changed as well.

Medicare says to use Place of Service 11 for Medicare claims.  On March 30th 2021, CMS released an interim rule with other changes.

When billing Telemedicine claims for services rendered on or after March 1, 2020, and for the duration of the Covid-19 emergency declaration:

  • Include Place of Service (POS) equal to what it would have been had the service been furnished in person (e.g., 11 for Office)
  • Append modifier 95 to indicate the service took place via Telemedicine

Note:  The CR modifier is not required when billing for Telemedicine services.

You can get more information on documentation and requirements in another post.  If you’re interested in a full breakdown, you can check out this article on Telemedicine Documentation Requirements.

Note:  There are other guidelines for patient-initiated visits which are not included in this article.  For non-physician initiated services check the carriers website or visit for additional information.

Telemedicine offers so many benefits to your patients:

  • They no longer need to travel (Many patients have transportation issues. They no longer drive, must depend on friends or family to bring them to the office, or just don’t have anyone to drive them)
  • Helps patients who are immunosuppressed or have illnesses or conditions that prohibit them from unnecessary exposure to Covid or other diseases
  • Greatly assists patients who have disabilities making it difficult to get to the office
  • Bad weather: snow storms, freezing or severe rain, extremely hot or cold conditions, floods, tornado warnings, or hurricane advisories

So, how do your patients feel about the no-contact visits?  Telemedicine is becoming a commonly used method of patient care in many specialties. Patients love the convenience; especially for the above mentioned reasons.  Based on recent surveys, 89% of patients are giving positive feedback regarding their virtual experience and 76% say they would encourage Telemedicine visits to their friends and family.  Those are great stats.

But your patients aren’t the only ones who can benefit.  Your practice will reap huge rewards in spades.  Practices can:

  • Recaptures lost revenues that are usually performed for free
  • Extends you patient market by seeing patients from multiple office locations without having to travel
  • Increases compliance as staff can call patients to set up follow-up appointments, remind patients of visits, update medications refills or changes, and monitor postop progress or complications, etc.
  • Utilizes the pay-per-visit system based solely on time
  • Decreases no-shows resulting in significant increased revenue
  • Allows consultations to be seen same-day or within a short period of time

Why lose all the practice income when you are just a phone call away?

Telehealth requirements are currently fluid.  Always check your carrier’s website for appropriate billing guidelines.  Additional changes may frequently occur during PHE (Public Health Emergency).

Ok Telemedicine, let’s get started!

How do you let your patients know that you’re booking Telemedicine appointments?  Get the word out!

Do a mail out!  When was the last time you did some good old-fashioned mail marketing?  Send a postcard and or a sealed letter to your patients informing them that you now are offering Telemedicine visits. Sample Postcard and Patient Information Letters

Letter for consults.  Send a letter to providers that regularly request consultations from you. Sample Postcard and Patient Information Letters

Coordinate with your staff and try to convert office visits for established patients to Telemedicine visits.  You can even call them on the day when the office is closed and schedule a Telemedicine visit.  The entire day doesn’t have to be non-profitable and the patients get the care they need.

Set your schedule!  For regularly scheduled visits, consider specific Telemedicine times in your weekly calendar.  Schedule one or two entire days dedicated to Telemedicine visits, if appropriate.  And perhaps, consider extending hours which can be performed at your office, home, or even at vacation location, etc.  Your staff can also work from home by communicating the scheduled or rescheduled visit information to your patients.

Finally, you need to keep a close eye on the Telemedicine rules and regulations as they may change once the Pandemic Emergency Health initiative is rescinded.  Also, carriers are reinstating their audit procedures starting 1-1-2022.  It is my belief that there will not be that many changes due to the healthcare system’s vast adoption of telemedicine and the reduced costs to the patients and carriers.

In closing, there is no reason or excuse not to make Telemedicine a part of your dermatology practice.  It is here to stay.  It will become a vital aspect of your practice’s income stream.   So, why wait?

For more information about our dermatology billing services contact us via our website.

Read more from our published resources:
Where is your Money Hiding?
It’s Time to Recall Your Skin Cancer Patients
Telemedicine Documentation & Equipment Requirements




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