EMT examining little girl's leg injury for telemedicine in-home visit

A New Normal? Telemedicine In-Home Visits May Include Primary Care

Integrating telemedicine into emergency medical services is nothing new, but the focus thus far has revolved around acute cases and specialties such as telestroke. However, in a recently released proof of concept, researchers questioned this trend and applied the model of telemedicine in-home visits to primary care services. This preliminary observatory study suggests that using telemedicine to bring primary care services into the patient’s home may be feasible, effective, and satisfactory for homebound seniors with chronic medical conditions. Read more

Woman writing "Fraud Prevention" on a clear board, referring to telemedicine fraud

Telemedicine Fraud Plagues Industry Growth

Last March, during the early days of the COVID-19 pandemic, Medicare temporarily eased the telemedicine requirements for reimbursement in order to increase access to care and reserve in-office visits for the sickest patients; in this way, Americans have been able to reduce exposure to COVID-19, for both themselves and healthcare workers, while continuing to receive needed care. However, the unprecedented rapid growth of telemedicine has been accompanied by a rise in telemedicine fraud cases and abuses. Whatever the error may be, the Department of Justice (DOJ) has begun holding offenders accountable for their actions. Ultimately, the telemedicine industry and healthcare providers will find themselves under closer scrutiny in the future. Read more

"Paid in Full" rubber stamp, representing zero cost sharing for telemedicine

Pandemic Freebies Are Ending—It’s Time for Cost Sharing for Telemedicine

During the anxiety-fraught early days of the COVID-19 pandemic, most major insurers joined the Centers for Medicare & Medicaid Services (CMS) in waiving co-pays and deductibles for telemedicine visits — cost sharing for telemedicine — in order to encourage people to remain at home, thus reducing possible exposure and transmission of COVID. The public, many of whom were new to telemedicine, readily adopted the technology in favor of convenience and safety, reduced costs, and less travel. Now, however, those halcyon days may be gone. Some major private health insurers have stated that as of Oct. 1, they are no longer paying the full costs for virtual visits that are unrelated to COVID; instead, patients are expected to pay a portion of the costs for the virtual visit, as is the norm for in-person visits. Read more

Gavel for Healthcare

Are Lightened Telemedicine Regulations Here to Stay?

As we’ve noted previously, the COVID-19 pandemic has thrust telemedicine into the spotlight with pro tem lifted telemedicine regulation, allowing both patients and providers to embrace low-contact methods for accessing healthcare. Now, several months into the COVID-19 pandemic, industry stakeholders are examining the currently active telemedicine regulations to determine which changes would encourage medical facilities and providers, ranging from small-practice primary care providers to tertiary care hospitals, to permanently add telemedicine to their routine options for health care delivery. Read more

Possible Telemedicine CPT Codes Shutdown Looms

Telemedicine CPT Codes in Danger

We may still be in the throes of the COVID-19 pandemic, but that isn’t stopping policy makers from planning ahead to determine whether temporary telemedicine CPT codes should be a permanent part of the “new normal” that is expected to reign after the emergency situation dissipates. As mentioned previously, quick changes to legislation, especially those that reimburse telemedicine visits at the same value as in-office visits, made telemedicine a much more convenient and financially viable alternative to the traditional model of in-office visits—for both patients and providers. As we look ahead to 2021, however, debate surrounds the Centers for Medicare and Medicaid Services (CMS)’ decision to drop a large majority of the recently-enacted billing codes, which may return the state of telemedicine almost to where it was before the pandemic began. Read more

Cheered businessman standing with graph showing growth trend of telemedicine for coronavirus

Emergency Measures Spur Growth of Telemedicine for Coronavirus, but What Comes Afterward?

Amidst the apprehension wrought by the current COVID-19 pandemic, a silver lining has emerged: Primary care providers (PCP) are finding that telemedicine usage within their practices, previously hindered by issues such as inadequate reimbursement, privacy concerns, and costs, has begun soaring as cautious consumers seek alternatives to visiting the doctor’s office in person and, thus, potentially exposing themselves or others to COVID-19. Industry analysts are predicting that as both providers and patients embrace telemedicine for coronavirus as a solution for reducing the risk of transmission of infectious disease, as well as for other ailments, they will become accustomed to telemedicine as a tool and will expect its continuation within medical practices. Read more

Telemedicine for Coronavirus: Drive-Through Testing

Telemedicine for Coronavirus: Next Window, Please

Telemedicine offers an ideal strategy to enable more health care providers to address more patients’ needs while minimizing exposure to infectious diseases such as the currently notorious coronavirus (COVID-19). As shown by the recent expansions for Medicare reimbursement for telemedicine, our Congress and President clearly recognize the potential benefits of utilizing telemedicine for coronavirus screening and other health care concerns. Even the New England Journal of Medicine came out a week ago with a strong statement of support for telemedicine’s benefits. Now, the question is how to deploy the technology quickly and in a way that will drive better outcomes for patients, providers and society as a whole. Read more

Handwashing complements telemedicine for coronavirus by reducing the spread of illness

Telemedicine for Coronavirus Cleared for Widespread Use

Telemedicine’s moment to shine has arrived. Amidst rising national concern regarding the spread of coronavirus COVID-19—on top of the annual influenza cycle—Congress has passed an emergency spending bill that expands Medicare reimbursement for telemedicine during a public health emergency by loosening restrictions on the permissible locations for patients during the consultation. Read more

RPM reimbursement codes clear the way for expanding RPM programs, such as glucose monitoring for diabetes patients

RPM Reimbursement Paves the Way for Expansion in 2020

With the ongoing shift in healthcare towards a value-based care model, the concept of remote patient monitoring (RPM) for chronically ill patients certainly grabbed attention throughout 2019. By introducing new reimbursement codes for RPM in late 2019, the Centers for Medicare & Medicaid Services (CMS) is clearly inviting the increased use of RPM, presumably made possible with telemedicine, in 2020. Some experts view 2019 as the trial run for RPM reimbursement; now that the CMS has officially endorsed RPM, albeit in limited capacities, 2020 is expected to see a significant rise in the adoption of RPM programs. However, current limitations in technology and software could curb growth, warn industry watchdogs. Read more

CT scan of Ischemic stroke for telestroke reimbursement

HHS Urged to Adopt New Mexico’s Telestroke Reimbursement Program

Over the last five years, several telestroke programs have flourished around the country, but only one has successfully garnered Medicaid coverage: New Mexico’s Access to Critical Cerebral Emergency Support Services (ACCESS) model. Now, in a bid for telestroke reimbursement, an advisory committee is suggesting that the Department of Health and Human Services (HHS) use the ACCESS program as a model for building a nationwide telestroke network backed by Medicare. Read more