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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

doctor answering survey for telemedicine adoption

Survey Finds Doctors Ready for Telemedicine Adoption Boom

A new survey by M3 Global Research and American Well has revealed that more physicians are using telemedicine now (22 percent) than in 2015 (5 percent), and the trend is expected to continue upwards; over half of US doctors expect to use the technology by 2022. The polled physicians cited a number of reasons for their readiness for telemedicine adoption, although some uncertainties remain. 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

young man sleeping with CPAP machine

Sleep Telemedicine Promises to Ease Shortage—But Only If It’s Reimbursed

As telemedicine has evolved over the years, sleep medicine has advanced accordingly to incorporate the growing technologies into the field. As described by Barry Fields, MD, MSEd, an assistant professor of medicine at Emory University School of Medicine and a sleep physician at the Atlanta VA Medical Center in a recent interview with Pulmonology Consultant, sleep telemedicine first began as telephone calls between the patient and provider. Now, anyone with a smartphone and the appropriate app can participate in synchronous (real-time) sleep telemedicine. 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