Wiki Telemedicine without patient

ca_cpc

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I'm wondering what the rules around telemedicine visits without patients might be. We've been allowing providers to bill audio-only visits on small children with just the parent on the call, because even if in the office the parent is the one involved in the conversation, providing history and receiving counseling. But now I have at least one provider beginning to do more video visits, and she's had a few where she specifically notes that the child isn't present. She's continuing to assume she can bill for these. This makes me nervous because in my mind the video platform offers similar exam opportunities to a child being in the office (even when not participating in the visit), and also because some of these are older kids who could feasibly be more involved. My inclination is to say these aren't billable, but does anyone have any guidance on telemed requirements regarding the presence of the patient?
 
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