Online Digital E/M (CPT 99421-99423)
CPT codes for online digital evaluation and management services provided by a physician for an established patient over the patient portal or other secure platform.
1 min read · Last reviewed May 23, 2026
At a glance
- Category
- Telehealth
- Primary sources
- 1
- Workspace handoff
- ask d3 →
Where this comes up
Telehealth coding, place-of-service, modifier (95, GT, GQ, FQ, FR), and post-PHE policy parity all converge here. State licensure rules and DEA controlled-substance prescribing rules add a second compliance layer most billers learn about only after the first denial.
Full definition
What it is in practice
99421-99423 stratify by cumulative time across a 7-day period. The service must be patient-initiated and cannot lead to an E/M within 7 days. Medicare PE/MP RVUs are modest.
How it shows up in your practice
Build portal-message workflow that captures and times the service. Many MA plans cover; original Medicare coverage varies post-PHE.
Sources
- CMS — Medicare Telehealth Services Listhttps://www.cms.gov/medicare/coverage/telehealth/list-services
Confirm online-digital E/M rules in Ask D3
Open ask d3 →Related terms
- TelehealthTelephone Visit (CPT 99441-99443)CPT codes for telephone evaluation and management services provided by a physician to an established patient when the call is not related to an E/M service performed within the previous seven days or leading to an E/M within 24 hours.
- TelehealthTelehealthDelivery of health care services through audio-video or audio-only technology when the patient is not at the same location as the practitioner.
- DocumentationPatient PortalA secure web-based application that lets patients access portions of their health information and communicate with the practice.
D3rx is a healthcare-billing and compliance research aid maintained by D3rx Inc. Articles are drafted by an LLM (Anthropic Claude) against primary HHS, OCR, CMS, eCFR, NIST, and state-regulator publications, and reviewed for restraint and source fidelity by the D3rx team.
Reviewer status: a named credentialed reviewer (CHC, CHPC, or healthcare attorney) is being engaged. Until that engagement is finalized, this page does not claim credentialed review.
Related across the archive
- GlossaryTelehealthDelivery of health care services through audio-video or audio-only technology when the patient is not at the same location as the practitioner.
- GlossaryTelephone Visit (CPT 99441-99443)CPT codes for telephone evaluation and management services provided by a physician to an established patient when the call is not related to an E/M service performed within the previous seven days or leading to an E/M within 24 hours.
- GlossaryPatient PortalA secure web-based application that lets patients access portions of their health information and communicate with the practice.
- GlossaryAudio-Only TelehealthTelehealth services delivered via telephone or other audio-only technology, without a video component.
- GlossaryDistant SiteUnder Medicare telehealth rules, the location of the practitioner delivering the telehealth service.
- GlossaryModifier 93 (Audio-Only Synchronous Telehealth)CPT modifier indicating a synchronous telemedicine service rendered via audio-only technology.
- GlossaryModifier 95CPT modifier indicating a synchronous telemedicine service rendered via real-time interactive audio and video.
- RegulationMLN: Medicare Telehealth ServicesReference to Medicare's telehealth policy: covered services list, originating and distant site rules, technology requirements, and the COVID-era flexibilities and their post-PHE status.
This glossary entry is a research aid for billing and compliance staff. It does not provide legal, medical, or financial advice and does not replace counsel. References cited link to primary sources at HHS, OCR, CMS, eCFR, NIST, and the relevant payer or industry body.