1.0 CPT CODE
S RANGE99241 - 99255, 99446
- 99449, 99451, 99452
2.0 DESCRIPTION
A deliberation with a specialist
physician, dentist, or qualified mental health provider requested
by the attending physician primarily responsible for the medical
care of the patient, with respect to the diagnosis or treatment
in any particular case.
3.0 POLICY
3.1 ConsultationsTRICARE
covers consultations performed by an a
TRICARE-authorized, individual professional provider
at the request of the patient’s attending provider are
covered.
3.2 A consulting
physician, dentist, or qualified mental health provider may perform
a limited examination of a given system or one requiring a complete
diagnostic history and examination.
3.3 To qualify as a
consultation,The contractor shall require a
written report to the attending physician of the consultant’s findings is
required to cover a visit as a consultation.
3.4 TRICARE covers interprofessional
Internet consultations conducted via the Internet and telephone (Current
Procedural Terminology (CPT) codes 99446-99449, 99451, and 99452),
including a verbal and written report to the patient’s treating/requesting
physician or other TRICARE-authorized provider. See Chapter 7, Section 22.1.
4.0 EXCLUSIONS
4.1 Telephone consultations
and telephone toll charges are not covered.
4.2 Staff consultations required
by the policies of a hospital or other institution.
5.0 EFFECTIVE DATES5.1 May 12, 2020, for telephonic
consultations during the Coronavirus Disease 2019 (COVID-19) pandemic.
5.2 July 1, 2022, for telephonic
consultations.