The short version
- An eConsult is a written specialist opinion delivered through the chart instead of through a referral visit.
- The treating provider sends the case (history, labs, images, and a clear question). A board-certified specialist sends back a written report.
- It is billable under CPT 99451 (specialist) and CPT 99452 (treating provider) when documentation rules are met [1].
What an eConsult actually is
"eConsult" is short for electronic consultation, also called an interprofessional internet/EHR consultation in CPT. It is a structured, asynchronous question from a treating provider to a specialist — answered in writing, in the chart, by a board-certified specialist who never sees the patient directly.
The point is to get the specialist's clinical judgment on the case without sending the patient to a separate visit. The treating provider keeps the relationship, finishes the workup, and documents a plan grounded in specialist input.
How an eConsult is different from a curbside
A curbside is a hallway question — informal, undocumented, and usually unpaid. The specialist takes on medical-legal risk for free, and nothing about the conversation is in the patient's chart [2].
An eConsult is the same clinical question, made official: a written request, a written reply, both attributed in the chart, and reimbursable on both sides. See our deeper write-up on curbside vs eConsult.
How it gets billed
The specialist bills CPT 99451 for a written report of five or more minutes. The treating provider bills CPT 99452 for sixteen or more minutes spent preparing and referring the case. Both require the patient's documented consent and a written specialist report in the chart [1][3].
For the full billing walkthrough, see CPT 99451 & 99452 explained.
When an eConsult is the right tool
- The answer will change the treatment plan and needs to be in the chart.
- The case does not require an in-person exam or procedure.
- The patient would otherwise wait weeks for a specialty appointment.
- You want to keep the patient in your practice instead of handing off the relationship.
Frequently asked
What does eConsult stand for?
eConsult is short for electronic consultation, also called an interprofessional internet/EHR consultation. The treating provider asks a specialist a clinical question through the chart; the specialist replies in writing.
Is an eConsult the same as telemedicine?
No. Telemedicine usually means a live video visit between the specialist and the patient. An eConsult is provider-to-provider and asynchronous — the specialist never sees the patient directly.
Is an eConsult billable?
Yes. The specialist bills CPT 99451 for a written report of 5+ minutes. The treating provider bills CPT 99452 for 16+ minutes spent preparing and referring the case. Both require documented patient consent and a written specialist report in the chart.
Who answers an eConsult?
A board-certified specialist in the relevant specialty. The treating provider keeps the patient relationship; the specialist provides written input that becomes part of the patient's record.
References
- 1.American Medical Association. CPT Professional 2024 — Interprofessional Telephone/Internet/Electronic Health Record Consultations (99446–99452). AMA, 2023. https://www.ama-assn.org/practice-management/cpt
- 2.Cohen MS. The risk of the curbside consultation: peril of informal consultations. J Am Coll Surg. 2016;223(2):395–399.
- 3.Centers for Medicare & Medicaid Services. Medicare Physician Fee Schedule — final rule (CY 2024). Federal Register, Nov 2023. https://www.cms.gov/medicare/payment/fee-schedules/physician
This article is for general educational purposes only and is not medical, legal, billing, or coding advice. Reimbursement rules and amounts vary by payer, state, and year — confirm with a qualified billing professional and your payer's current policy before acting on anything here.
See how Beam approaches this in practice
Beam runs same-day specialist consults documented in the chart. The fit depends on your setting and payer mix — happy to walk through it.