Since Current Procedural Terminology (CPT®) 2008 established the non–face-to-face nonphysician telephone service codes (98966–98968), there has been increasing confusion about the definition of a qualified nonphysician health care professional and consequently who can report the services. The codes used to report these services are
Note that the CPT terminology qualified nonphysician health care professional is not synonymous with the Centers for Medicare & Medicare Services (CMS) term nonphysician practitioner (see Table).
The lack of a CPT definition for a qualified nonphysician health care professional and the limitation of the CMS definition of a nonphysician practitioner leaves appropriate use of the codes open to interpretation. After lengthy discussion and consideration of this issue, the American Academy of Pediatrics Committee on Coding and Nomenclature has Telephone Services Provided by a Qualified Nonphysician Health Care Professional developed the following recommendations for reporting these services:
Clinical staff (eg, registered nurses) may appropriately...