e-Visits
Effective 2/1/25:
E-Visit Information and Billing Policies
Pediatric Surgical Associates is committed to offering accessible and convenient care through our secure Patient Portal/Healow App. This service allows patients to ask general questions, seek non-urgent advice, and discuss ongoing health concerns with our nursing team.
In certain cases, your inquiry may require input from one of our providers, involving a higher level of medical decision-making. When this occurs, the interaction may qualify as an e-visit, which is billed in accordance with our standard billing policies.
What types of messages may incur a fee?
Inquiries requiring significant medical decision-making by one of our providers that typically would have been provided during an in-office visit, will be billed to your insurance provider under applicable CPT codes:
- 99421 (5-10 minutes) – $50.00
- 99422 (11-20 minutes) – $100.00
- 99423 (21+ minutes) – $150.00
Exemptions (Messages that will not be billed):
- Prescription refill requests
- Billing inquiries
- Messages initiated by the care team
- Follow-up questions within 7 days of a prior appointment
Service Requirements for Billing
To ensure transparency, e-visits will only be billed if all the following conditions are met:
- The message is initiated by the patient.
- The patient is an established patient in our practice (seen within the past 3 years).
- Medical decision-making by a qualified healthcare professional is required.
- The inquiry is unrelated to an office visit within the past 7 days, and no follow-up visit (in-person or telehealth) occurs within 7 days of the message.
If you have any questions about this policy or your billing statement, please contact our office. We are here to help ensure you receive the highest quality care while maintaining clarity and fairness in our billing practices.