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

Telemedicine coverage illustrated by private payer administrator paying telemedicine doctor

Telemedicine Coverage Growing Rapidly, Says ATA Survey

The results are in: 80 percent of US states have taken action to improve telemedicine coverage or reimbursement over the last two years, according to the American Telemedicine Association’s latest survey of state laws and policies. However, each state is working alone in implementing these changes, forcing physicians who practice in more than one state to juggle confusing guidelines. Read more

Doctor at desk talking to patient with telemedicine solutions

Will Telemedicine Solutions Ease Physician Shortage?

For the next 20 years, three million baby boomers will reach retirement—each year, according to Advisory Board. Today, one in five people already lives in an area with a shortage of primary care physicians, and some hospitals are already experiencing a shortage of specialists; what will happen when we keep adding more patients than doctors to the healthcare system? Many experts, such as the Association of American Medical Colleges, predict that the shortage will only worsen. In a proactive effort to alleviate the problem and increase patients’ access to physicians, some hospitals and health systems have begun encouraging their patients to use telemedicine solutions instead of traveling to the doctor’s office, thus enabling physicians to see more patients more efficiently. Read more

ambulance with telemedicine reimbursement

Ambulances in Line for Telemedicine Reimbursement

Starting early next year, the U.S. Department of Health & Human Services (HHS) will begin a trial program with new financial incentives, including telemedicine reimbursement, to encourage emergency medical services (EMS) to use telemedicine and transport Medicare and Medicaid patients to clinics other than the emergency room. Currently, only visits to hospitals, skilled nursing facilities, and dialysis centers are reimbursed, even when a lower-acuity destination may be more appropriate. The goal is two-fold: to promote a value-based payment system and to reduce unnecessary ER visits and hospitalizations. Read more

stethoscope resting on fanned-out money representing telemedicine reimbursements

What’s Next for Telemedicine Reimbursements in 2019

The recent addition of new telemedicine Current Procedural Terminology (CPT) codes may have opened the door for more widespread usage of telemedicine, but it also carries implications for telemedicine reimbursements. This article outlines the some of the most likely developments for 2019 and beyond as predicted by industry analysts Akerman LLP. Read more

Two doctors reviewing brain scans on hospital computers

Telemedicine Reimbursement, Savings, and Care—Oh, My!

The Centers for Medicare & Medicaid Services has accepted five new Current Procedural Terminology (CPT) codes to allow physicians to be reimbursed for telemedicine specialist consultations and to expand remote patient monitoring conducted via telemedicine. The telemedicine reimbursement codes were originally proposed by the American Medical Association; now approved, they took effect on Jan. 1, 2019. Read more

handing over stacks of cash

Did Medicare Overpay for Telemedicine Reimbursement?

Amidst concerns that current levels of telemedicine reimbursement are insufficient to support the demand for telemedicine visits, a 2018 report by the Department of Health and Human Services Office of Inspector General (OIG) reveals that a significant portion of the Medicare telemedicine payments that have occurred were actually improper; they never should have been approved in the first place. The overpayments amounted to roughly $3.7 million—a sizable chunk of the total $13.8 million in payments that Medicare made in 2014 and 2015. The reasons for the disallowed claims were numerous and varied. Read more

paper money falling into piggy bank

Telemedicine Cost Savings Are Just Beginning

Telemedicine has long been touted as a balm for rising healthcare costs. Indeed, a 2017 report from the Rural Broadband Association found that annual telemedicine cost savings averaged $20,841 per hospital in the US. Some believe that telemedicine, including remote patient monitoring, could shave a combined $4.3 billion off the country’s yearly healthcare bill. While a first glance at the cost savings looks promising, digging deeper reveals that several obstacles are still preventing us from maximizing the benefits of telemedicine; this suggests that, with full support, cost savings could be driven higher yet. Read more

farm along country road in Southern York County, PA

Rural Telemedicine Growing More Slowly than Expected

Telemedicine has been touted as a revolutionary solution to the shortage of physicians in rural areas, but a recent study published in JAMA suggests that although this trend may have begun, it has not yet snowballed as expected. Between 2005 and 2017, 83.3% of patients with commercial insurance who used telemedicine services lived in urban areas. This suggests that they were not driven to use telemedicine by a shortage of physicians, but rather by other factors such as convenience. Such a surprising result seems contrary to the belief that rural patients are seeking greater access to physicians; if this were the case, then one might expect more rural telemedicine than urban telemedicine. Read more

bar graph growing upwards w magnifying glass

Telemedicine Usage Exploding since 2005

According to a new study published in JAMA, telemedicine use has been skyrocketing since 2005. Researchers, curious about the adoption pattern of telemedicine, examined the trends in telemedicine use and its association with factors such as parity legislation and physician supply within a large commercial health plan. They found that from 2005 to 2017, telemedicine usage grew from 206 visits in 2005 to about 202,300 visits in 2017. Telemedicine usage expanded the most in primary care and telemental health (telepsychiatry); this rise, they surmise, may be largely due to increasing payer coverage for direct-to-consumer telemedicine. Read more