elderly woman at home on telemedicine visit

New Budget Deal Boosts Telemedicine Coverage

Earlier this month, President Donald Trump signed into law a bipartisan budget deal that impacts Medicare’s telemedicine coverage more than any past legislation, as described by one senator. After a brief government shutdown, Congress approved a two-year budget deal including parts of the Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act, the Furthering Access to Stroke Telemedicine (FAST) Act, and the Increasing Telehealth Access to Medicare Act. Read more

occupational therapy

Texas Considers Expanding Telemedicine Reimbursement for Workers’ Comp Cases

Now that Texas state officials have finally opened the doors for telemedicine expansion, they certainly aren’t wasting any time: The Texas Division of Workers’ Compensation (DWC) has proposed an informal rule that would eliminate Medicare-based restrictions on originating sites and reimbursement for workers’ comp cases. Read more

physiotherapist helping woman

Telemedicine Can Reduce Hospital Readmissions

As Medicare applies increasing pressure to lower hospital readmission rates, skilled nursing facilities (SNF) are finding that telemedicine may hold the key. A recent study conducted by the TRECS Institute (Targeting Revolutionary Elder Care Solutions) found that using a virtual physician service averts unnecessary transfers from SNFs to hospitals. Read more

illustration of man having stroke

Telestroke Bill Would Expand Medicare Coverage

Congress is revisiting a bill that seeks to extend Medicare reimbursement for telestroke services across the nation. Under the Furthering Access to Stroke Telemedicine (FAST) Act, Medicare would cover telestroke services regardless of the patient’s location; currently, coverage only encompasses specific rural areas. Read more

medical claim form with stethoscope and pen

New Telemedicine CPT Codes Created

After a long wait, the Current Procedural Terminology (CPT) codes have finally been updated to include telemedicine. A “95” modifier can be added to CPT codes for real-time remote encounters with a video and audio component; the list includes outpatient evaluation and management (E/M) codes, consultation codes, and behavioral health codes, among others. Additionally, a new place of service (POS) code, telemedicine CPT code 02, is required for clinicians who bill for telemedicine services. Read more

MACRA consists of the APM and MIPS programs

Medicare Reimbursements Shift towards Quality of Care

In an open letter last Friday, October 14, the Centers for Medicare and Medicaid Services (CMS), announced the finalized policies for implementing the new Medicare Quality Payment Program (QPP). Although the rule takes effect on January 1, 2017, several components will be phased in over the next few years to give physicians time to adjust accordingly. Many of the policies have been updated from the previous proposal in response to feedback from clinicians across the country. Read more

Doctor holding sign that says, "Medicare"

Telemedicine Use Rising Rapidly among Medicare Beneficiaries

In one of the first published studies to measure exactly how often telemedicine is utilized, Harvard Medical School researchers discovered that telemedicine use among Medicare patients grew roughly 28 percent each year between 2004 and 2013. This rise is even more impressive in light of Medicare’s restrictive reimbursement policy: Medicare only pays for telemedicine visits if the patient lives in a rural area and travels to a clinic for the telemedicine visit. Read more

Doctor with tablet

ATA and AMA Team Up to Increase Reimbursement for Telehealth

In a move aimed at increasing reimbursement for telehealth services, the American Telemedicine Association (ATA) and American Medical Association (AMA) are working together to suggest new CPT codes to the Centers for Medicare & Medicaid Services (CMS) later this month. If accepted, the new codes would allow CMS to recognize and reimburse more telemedicine services. Read more

reimbursement for telemedicine

Medicare Falls Behind in Reimbursement for Telemedicine

You might think that the passage of the Affordable Care Act in 2010 and the resulting opportunities for telemedicine would have led to widespread telemedicine usage to increase access to healthcare while reducing costs, but the reality is that reimbursement from government agencies—such as Medicare—has fallen far behind the rhetoric. And when good intentions aren’t backed up with adequate funding, progress can become slower than molasses.

Telemedicine has certainly grown steadily, but the impact has been felt more significantly among those with private insurance that provides reimbursement for telemedicine visits. Among Medicare beneficiaries, less than 1% have coverage for telemedicine (1). And of those who are fortunate enough to enjoy such coverage, particularly those in rural areas, Medicare often requires the beneficiary to already be at a clinic. So much for making healthcare more convenient. Read more

New York Telehealth

New York joins the Telemedicine Party…er, Parity

New York Telehealth

Making a momentous step forward, last week New York Governor Andrew Cuomo signed into law a bill requiring private insurers to cover telehealth and telemedicine coverage, retroactive to January 1st, 2015 (Happy New Year!).

That was not a redundant sentence: New York has differentiated between telehealth and telemedicine in the bill, with the primary difference being that telemedicine must include Read more