GKIM Telehealth Platform

CPT Optimization Platform

This platform helps telehealth practices maximize compliant billing revenue in real time. It maps each patient encounter against Medicare's CPT code eligibility requirements, identifies gaps, and surfaces the fastest actions to close them — without overbilling or guesswork.

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Billing Consultant

An AI agent you can question in plain English. Ask why a CPT code isn't billable, what's missing, or how to unlock more revenue for a specific encounter. It reasons against the internal requirement model (R1–R23) and flags compliance risks.

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CPT Database

Browse the underlying data model powering the platform — 17 Medicare CPT codes, the full R1–R23 requirement system, the CPT-to-requirement mapping, and the fulfillment action library that defines how each requirement can be satisfied.

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Doctor UI

A mockup of the physician-facing interface. During a live encounter the sidebar shows real-time revenue status across all billable CPT codes, a prioritized action queue ranked by revenue-per-minute, and a CPT progress tracker.

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How it works

State Builder — Ingests raw EMR data and converts it into a structured CURRENT_STATE, tracking which of the 23 requirements have been satisfied for each CPT code.

Optimization Engine — Runs the CPT model against CURRENT_STATE to identify which codes are eligible, near-eligible, or blocked, then selects the highest-value fulfillment path.

Fulfillment Layer — Surfaces ranked actions to the physician in real time (auto, assisted, or manual), minimising time burden while maximising compliant revenue per encounter.

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CPT Billing Consultant

Ask about CPT code eligibility, requirements, and revenue optimization for your telehealth encounters. I reference the system's internal R1–R23 requirement model and fulfillment actions.

Code	Name	Category	Encounter Type	Time Req.	Frequency
99213	E/M low	E/M	Sync	20–29 min	Per visit
99214	E/M moderate	E/M	Sync	30–39 min	Per visit
99215	E/M high	E/M	Sync	40–54 min	Per visit
G2211	Visit complexity	E/M	Sync	N/A	Per visit
99453	RPM setup	RPM	Device	N/A	Once
99454	RPM supply	RPM	Device	16 days	Monthly
99457	RPM management	RPM	Monthly	≥20 min	Monthly
99458	RPM add-on	RPM	Monthly	+20 min	Monthly
99490	CCM basic	CCM	Monthly	≥20 min	Monthly
99491	CCM physician	CCM	Monthly	≥30 min	Monthly
99487	Complex CCM	CCM	Monthly	≥60 min	Monthly
99489	CCM add-on	CCM	Monthly	+30 min	Monthly
99424	PCM physician	PCM	Monthly	≥30 min	Monthly
99425	PCM add-on	PCM	Monthly	+30 min	Monthly
99484	Behavioral health	Behavioral	Monthly	≥20 min	Monthly
99421	E-visit (async)	Async	Async	5–10 min	7 days
G0439	Annual Wellness Visit	Preventive	Sync	N/A	Annual

ID	Name	Type	Description	Used By
R1	Established patient	Regulatory	Patient must be established with provider	99214
R2	Medicare eligibility	Regulatory	Patient must be Medicare eligible	—
R3	≥2 chronic conditions	Clinical	Patient has at least two chronic conditions	99490
R4	Single high-risk condition	Clinical	Patient has one high-risk condition	99424
R5	Consent documented	Documentation	Consent obtained and recorded	99457, 99490
R6	Annual consent	Documentation	Consent renewed annually	—
R7	≥20 min time	Time	At least 20 minutes accumulated	99457, 99490
R8	≥30 min physician	Time	At least 30 physician minutes	99424
R9	Incremental time	Time	Additional time increments	—
R10	Interactive communication	Clinical	Real-time patient interaction	99457
R11	Audio allowed	Regulatory	Audio-only acceptable	—
R12	Async allowed	Regulatory	Asynchronous interaction allowed	—
R13	FDA device	Clinical	Use of FDA-defined device	99457
R14	≥16 days data	Data	Device data collected ≥16 days	99457
R15	Physiologic data	Clinical	Collection of physiologic data	—
R16	Care plan	Documentation	Care plan established	99490, 99424
R17	Longitudinal care	Clinical	Ongoing care relationship	G2211
R18	Medication management	Clinical	Medication decisions made	99214
R19	CCM vs PCM exclusion	Regulatory	Cannot bill CCM and PCM together	—
R20	Single billing practitioner	Regulatory	Only one provider bills	99424
R21	MDM documented	Documentation	Medical decision making documented	99214
R22	Time log	Documentation	Time is logged and auditable	99457, 99490
R23	Signed note	Documentation	Encounter note signed	99214

CPT Code	Name	Required Requirements	Count
99457	RPM mgmt	R5 R7 R10 R13 R14 R22	6
99490	CCM basic	R3 R5 R7 R16 R22	5
99424	PCM physician	R4 R8 R16 R20	4
99214	E/M moderate	R1 R18 R21 R23	4
G2211	Visit complexity	R17	1

ID	Requirement	Method	Action	Time Cost	Automation	Reliability	Priority
F1	R5	AI	Send e-consent to patient	0 min	Auto	0.95	10
F2	R7	Physician	Add 5 min to encounter time	5 min	Manual	1.00	7
F3	R10	AI	Trigger interaction call	1 min	Assisted	0.90	9
F4	R16	Physician	Create patient care plan	5 min	Manual	1.00	6

Sarah Mitchell

DOB: 03/14/1958 · RPM · CCM · Encounter #4 this month

Session Time

22:14

▲ R7 threshold met

Vitals (from RPM device)

138/86

72 bpm

SpO₂

97%

Weight

164 lb

Glucose

118 mg/dL

Clinical Notes

Patient reports improved adherence to medication schedule. BP trending down from 148/92 last visit. Discussed dietary modifications — patient receptive. No new complaints. Continue current lisinopril 10mg QD. Follow up in 30 days or sooner if BP rises above 150 systolic.

Encounter Activity Log

E-consent sent and confirmed

09:02 AM

RPM device data ingested (7-day window)

09:03 AM

Interactive video call initiated

09:05 AM

Care plan — pending physician action

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Action Queue

Create care plan

Unlocks 99490 · +$60 · 5 min

+$60

Add 8 min to 99424

Needs ≥30 min · currently 22 min

+$90

Document MDM complexity

Confirm 99214 moderate MDM

Secure