Online Medical Evaluation Services

Billing and Reimbursement
Policy Number: RP-P-035

Last Updated: Nov. 29, 2023 

Online medical evaluation services are non-face-to-face encounters using internet resources originating from an established patient to a physician or other qualified health care professional for evaluation or management of a problem. The service includes all communication, prescription and laboratory orders with permanent storage in the patient's medical record. The service may include more than one provider within the same provider group responding to the same patient and is only reportable once during seven days for the same encounter. Collective time devoted to the service may include:

  • Review of initial inquiry.
  • Review of patient records or data pertinent to assessment of the patient’s problem.
  • Personal physician or QHP interaction with clinical staff focused on the patient's problem.
  • Development of management plans, including generation of prescriptions or ordering tests.
  • Subsequent communication with the patient through online, telephone, email or other digital communication which does not represent a separately reported E/M.

Online evaluation and management services are reimbursed once every seven days by the same provider group. Services submitted with POS 02 or 10 will deny.