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Family PACT: Virtual/Telephonic Communications

Originally published March 26, 2020 and updated on April 8, 2020

In light of the United States Health and Human Services Secretary’s January 31, 2020, public health emergency declaration, the California Governor’s March 4, 2020, emergency declaration and the President Trump’s March 13, 2020, national emergency declaration relative to coronavirus disease 2019 (COVID-19), the Department of Health Care Services (DHCS) is issuing additional guidance relative to virtual/telephonic communications for Family PACT providers.

Effective for dates of service on and after March 19, 2020, Family Planning, Access, Care and Treatment Program (Family PACT) is adding HCPCS codes G2010 and G2012 (virtual/telephonic communications) as benefits under the program to align with existing Medi-Cal telehealth coverage policy as noted in the “Medicine: Telehealth” section of the Medi-Cal Provider Manual.

Virtual communication includes a brief communication with another practitioner or with a patient who cannot or should not be physically present (face-to-face) as described in the following:

  • HCPCS Code G2010: Remote evaluation of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related E/M service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment
    • Rate: $10.87
  • HCPCS Code G2012: Brief communication technology-based service, e.g., virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related E/M service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion. G2012 can be billed when the virtual communication occurred via a telephone call
    • Rate: $12.48

Family PACT services rendered using telehealth modalities must follow the International Classification of Diseases ICD-10-CM codes billing policy as noted in the Family PACT Policies, Procedures and Billing Instructions manual.

Upon system implementation, any affected claims will be automatically reprocessed via an erroneous payment correction (EPC). No action is required of providers.