Telemedicine is about to get a huge boost from Medicare and Medicaid approval
The Centers for Medicare & Medicaid Services (CMS) enables providers to get payment for telehealth services under the corresponding billable codes such as HCPCS code G0296, CPT code 90785, CPT codes 96160 and 96161, HCPCS code G0506 and CPT codes 90839 and 90840
November 16, 2017 by Connor Forest
A proposed rule in the Medicare Physician Fee Schedule in 2018 would cover expenses related to remote patient monitoring, potentially fast-tracking telehealth services.
The Centers for Medicare & Medicaid Services (CMS) recently proposed a rule addressing Medicare payment for certain telehealth and telemedicine services. The proposal is listed in the updates to the Medicare Physician Fee Schedule for Calendar Year 2018, with a distinct focus on remote patient monitoring.
CMS operates around specific billable codes. For 2018, the organization could be adding seven more codes that address telehealth services. Here are those code additions, per the CMS website:
- HCPCS code G0296 (visit to determine low dose computed tomography (LDCT) eligibility)
- CPT code 90785 (Interactive Complexity)
- CPT codes 96160 and 96161 (Health Risk Assessment)
- HCPCS code G0506 (Care Planning for Chronic Care Management)
- CPT codes 90839 and 90840 (Psychotherapy for Crisis)
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One of the existing codes in question is code 99091, which describes certain remote patient monitoring. According to the provisions in the fee schedule, CMS is still setting a specific definition of remote patient monitoring and addressing situations that involve strong use of communications technology.
The provisions also noted that CMS is working on finalizing separate payment for code 99091 regarding the collection, storage, and transmission of physiological patient data; while also considering how to “further expand access to telehealth services within our current statutory authority.”
The proposed changes have brought praise from the Consumer Technology Association (CTA).
“Connected health is changing our lives for the better – helping us care for our loved ones from far away, track our own wellness and work with our doctors more closely than ever,” CTA president and CEO Gary Shapiro said in a press release. “The field of medicine is evolving rapidly, led by remarkable innovations in health information technologies and remote health care services. These changes are already disrupting the current models of health care delivery and the established payment framework.”
One of the major benefits of telehealth is accessibility, especially for people who may live in a rural area far away from a doctor’s office. It can also cut down on costs and the time associated with a doctor visit, as patients can more easily get quick questions answered from their computer or tablet. By handling these problems remotely, this could free up doctors to focus on more critical patients and lessen wait times at hospitals as well.
Tech companies like Google have been experimenting with telemedicine for years, but the practice hasn’t yet taken off in a major way. With more support from CMS, and the growing use of big data in healthcare, telehealth could be set to explode in the coming years.
The 3 big takeaways
- The Centers for Medicare & Medicaid Services (CMS) recently proposed a rule clarifying its approach to remote patient monitoring and expanding its telehealth initiatives.
- The proposal includes a redefinition of one CMS code and the addition of seven others. The proposal has been praised by the Consumer Technology Association (CTA).
- Telehealth could help lower the cost and amount of time it takes to see a medical professional, while also freeing doctors up to focus on the sickest patients.