How to Get Paid for Patient Messages: A Step-by-Step Guide for ClinicsÂ
If you're a provider in the U.S., you're probably answering dozens of patient messages each weekâmost of them unpaid. But did you know that under CMS guidelines, many of these interactions can now be reimbursed?Â
Thanks to CPT codes for digital E/M services, clinics can now receive payment for certain types of asynchronous communicationsâif theyâre documented and billed correctly.Â
The opportunity is realâbut so are the challenges: time tracking, documentation, eligibility checks, and coordination with billing teams. Thatâs where Ankr VCX becomes a game-changer.Â
In this blog, weâll explain:Â
Which patient messages are eligible for reimbursement  Â
What CMS requires for compliance Â
How to streamline time tracking and documentation  Â
And how Ankr VCX helps identify and prepare billable encountersâwithout disrupting your workflow Â
CMS Reimbursement for Patient Messages: What to KnowÂ
To better align with the realities of modern healthcare delivery, CMS introduced reimbursement codes for asynchronous digital evaluation and management (E/M) services delivered through secure messaging platforms.Â
These are the CPT codes:Â
99421 â 5â10 minutes Â
99422 â 11â20 minutes Â
99423 â 21+ minutes Â
These codes allow providers to be compensated for non-face-to-face patient care that still requires clinical decision-makingâwhen done over a 7-day period.Â
Important: These codes are not meant for follow-ups or appointment scheduling. The message must involve a new issue and require medical evaluation.Â
Step-by-Step: How to Bill for Patient MessagesÂ
Step 1: Confirm EligibilityÂ
Only certain messages qualify:Â
They address a new medical concern Â
They require clinical evaluation and decision-making Â
No related in-person or telehealth visit occurs within 7 daysÂ
Step 2: Track Cumulative TimeÂ
You need to document how much time was spent responding, reviewing charts or labs, and preparing a clinical response across 7 calendar days.Â
Step 3: Prepare Thorough DocumentationÂ
To bill compliantly, you must:Â
Record the start and end dates of communication Â
Note total time spent Â
Summarize the clinical responseÂ
Identify the provider involved Â
Step 4: Submit the ClaimÂ
Once the clinical note and time tracking are complete, the correct CPT code should be selected and submittedâtypically by your billing team or through your EHR.Â
How Ankr VCX Helps Streamline the ProcessÂ
While Ankr VCX does not perform billing on your behalf, it makes the process far more efficient by handling the most time-consuming and error-prone steps:Â
Flags eligible patient messages that may qualify for reimbursementÂ
Tracks time spent across patient communicationsÂ
Creates structured clinical notes using smart templates and provider inputsÂ
Integrates with EpicÂź, AthenaÂź, and eClinicalWorksÂź, so documentation lands in the right place, ready for reviewÂ
Reduces administrative burden so that your billing team has all the information needed to submit claims confidentlyÂ
Think of it as a smart assistant that helps you capture the value of care youâre already deliveringâwithout adding work to your day.Â
Why It Matters: What You Might Be Leaving on the TableÂ
Even a small clinic responding to 5â10 billable messages per day could be missing out on tens of thousands of dollars annually. Larger practices using Ankr VCX have uncovered over $1 million per year in previously untapped revenue by optimizing documentation and identifying eligible digital services.Â
The potential is there. The patients are already messaging you. The care is already happening.Â
You just need the right system to make it billable.Â
Final Thoughts: Turn Inbox Work Into Reimbursable CareÂ
Asynchronous care is now a core part of modern practiceâbut too often, it's still treated as unpaid work.Â
With CMS guidelines and a smart support system like Ankr VCX, clinics can bring structure, clarity, and value to patient messagesâwhile easing the load on their teams.Â
đ© Want to see how it works in your practice? Reach out to [email protected] to get started with Ankr VCX.Â

















