CPT Code 98968: Telephone Assessment and Management, 21-30 Minutes

Learn how to bill CPT code 98968 for 21-30 minutes of telephone assessment and management by nonphysician providers when no in-person visit is planned.

Use Code

What is telephone assessment and management?

The 98968 CPT code is used to report a telephone assessment and management service provided by a qualified nonphysician health care professional, such as occupational therapists, speech-language pathologists, physical therapists, or nurse practitioners. This code applies when an established patient, parent, or guardian engages in a telephone call with a provider for 21-30 minutes of medical discussion related to a specific issue.

Importantly, CPT code 98968 should be used only when the call is patient-initiated, there is no related assessment and management visit within the previous 7 days, and the discussion does not result in an in-person visit or telehealth service within the next 24 hours or the soonest available appointment.

This telephone service is often used in chronic care, behavioral health, or rehabilitative care when timely follow-up cannot be completed in person. It supports continuity of care, especially during times when physical visits are limited due to public health emergencies or other access barriers.

CPT code 98968 documentation requirements

To support billing and compliance for telephone assessment and management, the medical record should reflect:

Date and exact duration of the telephone call (must be between 21 and 30 minutes)
Identity of the established patient, or the parent/guardian if applicable
Medical necessity and the reason the call was required
Summary of the medical discussion, including the assessment and management service provided
Any counseling, recommendations, or treatment advice given during the call
Statement confirming that there were no related E/M visits in the prior 7 days, and no in-person or telehealth services planned within 24 hours or the soonest available appointment

CPT code 98968 billing guidelines

When coding telephone assessment and management service under 98968, follow these important billing rules:

Report this code only once per 7-day period per provider and same patient
Applies to calls lasting 21–30 minutes, measured in cumulative time
Must be a patient-initiated telephone service; provider follow-up or scheduling calls are not billable
If the telephone call leads to an in-person or telehealth visit within 24 hours, or the soonest available appointment, 98968 cannot be reported
Ensure the provider’s licensure allows for use of telephone service CPT codes
Not valid for use by physicians; see 99441–99443 for physician telephone visits

Other relevant CPT codes

98966 – Telephone E/M, 5–10 minutes
99441–99443 – Physician-led telephone assessment and management services

Frequently asked questions

Yes. Although telephone services are not classified as traditional telehealth billing under all payers, some Medicaid Services and private insurers allow billing for phone call encounters when audio-only interactive communication meets the criteria for a management service or procedure. Always follow up-to-date coding guidance for state-specific telehealth rules.

Yes, physician assistants, registered dietitians, and other qualified nonphysician providers may bill CPT codes 98966–98968, as long as the management service provided within the phone encounter falls within their licensure and scope of practice. Documentation must include pertinent information related to the patient’s concern or chronic conditions.

Telephone services should not be billed if they are originating from a related service or procedure within the previous 7 days, or if they lead to an in-person or telehealth visit within 24 hours or the soonest available appointment. The time spent on the call must be medically necessary and documented, not administrative.