We first researched our contracts -- none of them (including Medicare) preclude charging for telephone services, but none of them pay either. If you want to try to bill, the code is 99441: "5-10 minutes of medical discussion". It can't be related to any face to face contact within a week.
We dictate an Addendum in AC, stating that the patient called for the refill, chart was reviewed to confirm med dose and currency, and patient notified that their next F2F visit should be within X time period.
We began by notifying everyone who called for a refill or came in for an appointment that effective "this date", we would begin a charge for telephone refills (since at each of our appointments we already provide refills until well past the next visit). Their alternative is to come in for an office visit, with a limited refill provided until that time.
Almost no requests for refills by phone now, except some crisis situations, like lost luggage or different pharmacy. We are flexible in many cases.
