Reimbursement Guide for California Telemedicine

The telehealth community is often heard clamoring for more comprehensive guides to help practices and providers navigate the confusing and murky waters of reimbursement. The California Telehealth Resource Center has stepped up in a big way this month with the publication of their Telehealth Reimbursement Guide for California.  

While about half of the guide is limited to plans currently operating in CA, it’s a great overview of the type of reimbursement policies that exist for payers that have policies nationwide, as well as a great example of the type of details you will need when you call the payers you are contracted with to enquire what they cover (best practice when starting up and running a telehealth program). Also included in this guide are sections on definitions and general telehealth information, and a thorough section on Medicare reimbursement and policies. At the end, there is a set of scenarios surrounding virtual care delivery and Federally Qualified Health Clinics or Rural Health Clinics. The first three describe reimbursement policies under Medicare. 

While this guide is gold for California providers, it is also immensely helpful for any involved in the telehealth industry. California has a relatively progressive take on telehealth reimbursement, and could be a good benchmark for those advocating for policy advancements in their own states. The inclusion of the Medicare section really makes this a must-read for anyone involved in or interested in delivering telehealth services.  

One of the main reasons providers steer clear of telehealth is the lack of reimbursement or clear information on whether reimbursement from insurance payers is even possible. Guides like this attempt to meet that need in order to increase the number of providers able and willing to engage in this form of healthcare delivery. Telehealth, when used correctly, solves so many access-to-care problems, as well as saves money for both providers and patients. It is the responsibility of the telehealth champions to reduce and remove as many barriers to providers wanting to use telehealth as possible.  SimpleVisit applauds the CTRC for what they are doing to aid in that effort.

To download and read the guide, click here.

To see California Telehealth Resource Center’s full range of resources, or to contact them with your California-policy-related questions, click here.