I have been using the secure video chat in the office now, and finding new ways to use this technology in my established patients. With private patients for reimbursement, you have to have informed consent before the chat informing the patient there will be a charge for the secure chat, so I have made a template for this. Also, I am still working out how best to document, either using addendum or office visit, likely depends on the complexity and length of chat, but should use the equivalent time charge as an office visit, so will likely use a lot of 99212 or 99213's for this type of encounter. I will give an update in a month or two to share how this goes.
Now for medicare patients, using the secure video chat is a whole different beast. I think for medicare I will be using the chronic care management code for these folks.
