Medicare Telehealth Policy
The Centers for Medicare and Medicaid Services (CMS) has released an updated version of their telehealth fact sheet, expanded into an easy-to-read booklet format [linked at the bottom of the article].
Here’s what you need to know: CMS only reimburses for live video telehealth services under specific circumstances, including…
Scope of Coverage / Type of Encounter
- Consultations
- Office or other outpatient visits
- Individual psychotherapy
- Pharmacologic management
- Psychiatric diagnostic interview examination
- End Stage Renal Disease
- Individual medical nutrition therapy
- Neurobehavioral status examination
- Follow up inpatient telehealth consultations
- Transitional care management services
Geographic Location
Reimbursement for telehealth video conferencing can only occur when the originating site is:
- Located in a federal demonstration program;
- In a rural Health Professional Shortage Area (HPSA); OR
- A county that is outside of any Metropolitan Statistical Area (MSA), as defined by HRSA and the US Census Bureau.
Type of Providers
- Physicians
- Nurse Practitioners
- Physician assistants
- Nurse midwives
- Clinical nurse specialists
- Clinical psychologists and clinical social workers
- Registered dietitians or nutrition professionals
Originating Site Facility
- The offices of physicians or practitioners
- Hospitals
- Critical Access Hospitals
- Rural Health Clinics
- Federally qualified Health Centers
- Hospital-based or Critical Access Hospital-based Renal Dialysis Centers
- Skilled Nursing facilities
- Community Mental Health Centers
CPT & HCPCS Codes
CMS only reimburses for a limited number of CPT & HCPCS codes when services are delivered through telehealth. To view the list of reimbursable telehealth CPT & HCPCS codes for current year 2018, click here.
Other Telehealth Services
- There is no coverage for remote patient monitoring (RPM).
- CMS only covers store-and-forward for demonstration projects in Alaska and Hawaii.
(Information taken from Telehealth Resource Centers’ Medicare’s Telemedicine/Telehealth Payment Policies https://www.telehealthresourcecenter.org/toolbox-module/medicares-telemedicinetelehealth-payment-policies#current-medicare-policy )
To find out more about reimbursement for telemedicine using SimpleVisit, call us at 877.838.4748
The Costs of Offering A Telemedicine Program
"What will offering telemedicine to patients do to my bottom line?" This is the concern that many of my discussions with doctors has inevitably boiled down to. The answer, as you may expect, is not exactly straightforward. Figuring out if an investment...
5 Rules for Healthcare Virtual Visits
As payers and technology continue to develop in support of the rising trend of telemedicine, it is important for providers to understand the basic rules of practicing in the virtual world. Below are the five guidelines for healthcare providers offering...
Is FaceTime HIPAA Compliant?
Telemedicine Industry Article | 10 min read | Updated October 21, 2020This article first appeared on LinkedIn Pulse 05/15 by Jon Taylor of Bayon IT. In the first part of this series we wanted to address one of the most common questions we get asked; “Is FaceTime...