The 99442 CPT code described an established-patient telephone E/M service lasting 11–20 minutes. However, it is no longer a current CPT code.
The AMA deleted 99441, 99442, and 99443 for 2025. Providers now need to follow the newer audio-only E/M coding structure and payer rules. This change makes the 99442 CPT code important mainly for understanding older claims, historical billing, and the move to current telephone services.
What Was the 99442 CPT Code?
The 99442 CPT code was used for an evaluation and management service delivered by telephone to an established patient. The physician or other qualified healthcare professional had a medical discussion with the patient lasting 11–20 minutes.
The 99442 CPT code was different from an office visit because it described a telephone E/M service.
Before the 2025 CPT changes, providers commonly used these telephone E/M codes:
| Code | Historical service time |
| 99441 | 5–10 minutes |
| 99442 | 11–20 minutes |
| 99443 | 21–30 minutes |
These codes were deleted effective January 1, 2025. That change ended use of the 99442 CPT code for new 2026 claims. AMA guidance directs providers to newer synchronous audio-only visit codes for comparable services.
99442 vs 99441: What Was the Difference?
The main historical difference between 99442 vs 99441 was the length of the medical discussion.
- 99441 covered 5–10 minutes.
- 99442 covered 11–20 minutes.
Both were designed for established-patient telephone E/M services.
Providers should not use that historical comparison to choose a current 2026 code. The 99442 CPT code belongs to the older coding structure. Current code selection must follow the applicable 2026 CPT and payer rules.
Why Was 99442 Deleted?
CPT changed its approach to remote E/M services in 2025. The older telephone-only E/M codes were replaced by a broader telemedicine E/M code family.
For established patients, AMA directs users to CPT 98012, 98013, 98014, and 98015 for synchronous audio-only E/M services. New-patient audio-only services use 98008–98011.
This change matters because current code selection is not simply based on the old 11–20 minute rule. Providers must review the descriptor, medical decision-making requirements, time rules, and payer policy for the selected service.
2026 Current Coding: What Should Providers Know?
For 2026, providers should not report the 99442 CPT code as a current CPT telephone E/M code.
Instead, review the current audio-only E/M codes and the payer’s billing policy. AMA’s 2025 corrections document specifically cross-references deleted 99442 and 99443 to 98008–98015.
CMS also maintains a current Medicare telehealth services list and updates it by calendar year. Providers should verify the code’s Medicare status before submitting a claim.
This is especially important because CPT coding and Medicare payment policy are related but not identical. A code can exist in CPT while a payer applies different coverage or payment rules.
Historical Claims: What Providers Should Review
The historical comparison remains useful when reviewing older claims.
If a claim from before January 1, 2025 contains the 99442 CPT code, the billing team should review the date of service before deciding whether the code was appropriate. The service period matters because code status changed in 2025.
For example, imagine a provider billed a telephone E/M service in December 2024. The historical 99442 descriptor may be relevant to that claim.
Now imagine the same type of service occurred in 2026. The billing team should not automatically submit 99442. The current CPT structure and payer policy must be checked first.
Telephone Visit Billing Guide for Providers
A practical telephone visit billing guide should start with the date of service.
- Next, confirm whether the encounter was audio-only, audio-video, or another type of virtual service. Then identify whether the patient was new or established.
- After that, review the current CPT descriptor. Check whether selection depends on medical decision making, total time, or another coding requirement.
- The provider’s documentation should support the service billed. It should show the clinical reason for the encounter and the work performed.
- For audio-only services, also verify the payer’s rules for technology, modifiers, place of service, patient location, and coverage.
- The 99442 CPT code should not be selected simply because the encounter lasted 11–20 minutes. That time range describes the old code and does not establish current 2026 code selection.
Documentation Requirements
Good documentation helps connect the clinical work to the billed service.
For a telephone encounter, documentation should support:
- Date of service
- Patient identity
- Reason for the encounter
- Relevant symptoms, concerns, or condition
- Clinical assessment
- Medical decision making, when applicable
- Time, when time is used for code selection
- Treatment or management plan
- Follow-up instructions
- Required consent or telehealth elements
- Provider identity and credentials
Do not document only that “patient called” or “telephone visit completed.” That wording may not explain the clinical service well enough.
The note should show why the provider needed to communicate with the patient and what happened during the encounter.
Audio-Only Services and Modifier 93
Modifier 93 identifies a synchronous telemedicine service delivered through telephone or another real-time interactive audio-only system.
The AMA defines synchronous audio-only communication as a real-time interaction between the clinician and patient. The communication must be sufficient to meet the requirements of the reported service.
However, modifier use depends on the code and payer. Do not add modifier 93 simply because the encounter happened by phone.
Providers should verify the payer’s current billing instructions before submitting an audio-only claim.
Telephone E/M Reimbursement: What Affects Payment?
Telephone E/M reimbursement depends on more than the historical code description.
Payment can vary by payer, code, locality, contract, coverage policy, and patient benefit. Medicare payment also depends on whether the service is included in the applicable Medicare telehealth rules.
CMS provides a Physician Fee Schedule lookup tool for Medicare payment information. Providers can use it to check payment amounts and related policies for current codes.
Do not use an old 99442 reimbursement amount for a 2026 claim. Historical payment data does not establish the current allowed amount.
For commercial plans, the payer may have its own rules. A payer may also require specific modifiers or place-of-service reporting.
How Does 99442 Compare With Current Audio-Only Codes?
The biggest difference is that the 2026 coding approach is not a simple replacement of “11–20 minutes” with one new code.
The current established-patient audio-only family includes 98012–98015. Providers should read each descriptor carefully before selecting a code. AMA’s coding guidance specifically points to these codes for established-patient synchronous audio-only E/M services.
The exact selection depends on the service requirements. Time alone should not be used as a shortcut when the code requires medical decision making or other criteria.
A billing team should also confirm whether the payer recognizes the selected code for the date of service.
Medicare Considerations for 2026
CMS maintains a 2026 Medicare telehealth services list. CMS also states that Medicare telehealth claims should use the appropriate CPT or HCPCS code.
For RHCs and FQHCs, CMS has separate billing rules. CMS states that these organizations can continue reporting G2025 for certain non-behavioral health telecommunication services, including audio-only services, through December 31, 2026.
Starting October 1, 2026, CMS says RHCs and FQHCs must bill distant-site telehealth using the individual CPT or HCPCS code and appropriate telehealth modifier. CMS identifies modifier 93 for synchronous audio-only services.
This means facility type matters when reviewing a telephone encounter.
Common Billing Mistakes
One common mistake is using the deleted 99442 CPT code for a 2026 service.
Another mistake is choosing a current audio-only code based only on the number of minutes.
Other problems include:
- Missing documentation
- Incorrect modifier use
- Wrong place of service
- Ignoring payer-specific rules
- Using outdated Medicare guidance
- Assuming every telephone service is separately payable
- Reporting overlapping services
- Using an old reimbursement rate
- Failing to verify the date of service
Providers should build a simple verification process before claims reach the payer.
99442 and Other Virtual Services
Providers should also distinguish telephone E/M services from online digital E/M services.
Online digital E/M codes 99421–99423 are different services. They generally involve patient-initiated digital communication over a seven-day period. AMA continues to list these as online digital E/M services.
A telephone encounter should not be coded as an online digital E/M service simply because both occur remotely.
Likewise, remote patient monitoring, remote therapeutic monitoring, virtual check-ins, and audio-only E/M services have different coding requirements.
The communication method alone does not determine the correct code.
Frequently Asked Questions
Is 99442 still a current CPT code in 2026?
No. The code was deleted effective January 1, 2025. The 99442 CPT code therefore belongs to the historical coding set.
What did 99442 represent?
Historically, it represented an established-patient telephone E/M service with 11–20 minutes of medical discussion.
Can providers bill 99442 to Medicare in 2026?
Providers should not treat 99442 as a current Medicare telephone E/M code. Check the current Medicare telehealth list and applicable payer guidance.
What replaced 99442?
For synchronous audio-only E/M, AMA directs providers to the 98008–98015 family. The correct code depends on patient status and service requirements.
Does modifier 93 always apply?
No. Modifier 93 is used for qualifying synchronous audio-only services, but providers should follow the specific code and payer requirements.
How should providers check reimbursement?
Use the current Medicare Physician Fee Schedule when Medicare applies. For commercial plans, verify the payer’s contracted rate and billing policy.
Final Thoughts
The 99442 CPT code is now mainly a historical billing reference. Its former 11–20 minute telephone E/M description still helps providers understand older claims. However, it should not be used as a shortcut for 2026 coding.
The 2025 CPT changes moved synchronous audio-only E/M services into the 98008–98015 family. Providers should verify the current code, documentation, modifier, place of service, and payer rules before submitting claims.
For Medicare services, use current CMS resources and the applicable Physician Fee Schedule. CMS maintains its 2026 telehealth list and payment resources for this purpose.
Before billing an audio-only encounter, verify the current CPT code, payer policy, documentation, and reimbursement requirements.
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