Name:
Rheuban: Telemedicine Ch. 23: Medicare Coverage and Reimbursement Policies
Description:
Rheuban: Telemedicine Ch. 23: Medicare Coverage and Reimbursement Policies
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Duration:
T00H02M21S
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Content URL:
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Upload Date:
2022-02-27T00:00:00.0000000
Transcript:
Language: EN.
Segment:0 .
DR. RHEUBAN: Payment for telehealth, that's a huge thing. So, payment for telehealth has traditionally been either federal, through the federal government, like Medicare, or federal employee benefit plans do cover. Medicare is relatively limited, in terms of their reimbursement. They have significant originating site restrictions under fee-for-service Medicare. In fact, in 2014, the data provided by the Center for Telehealth and e-Health Law, provided to them by CMS, was that nationwide, Medicare only reimbursed $14 million in claims, nationwide for telehealth services.
DR. RHEUBAN: So, there are more opportunities and, as we alluded to, 2018 is a really great year, because there have been some changes in Medicare, changes in the budget bill, which incorporated the CHRONIC Care recommendations for expanding eligibility for acute stroke services to now rural and urban originating site hospitals. That's critical. And we can talk about stroke in a minute. Also, for dialysis patients, patients with end-stage renal disease, who have challenges getting back to the clinic facility.
DR. RHEUBAN: In many cases, a lot of dialysis facilities are remote, but patients are even more remote. So, to enable telemedicine services to be provided. And then, there's also expansion under ACOs and Medicare Advantage programs that was in the CHRONIC Care bill. So, that will, hopefully, expand adoption, because there will be expanded payment. And then in the physician fee schedule for 2018, which really thrilled me, personally, because we're trying to build out remote monitoring, is the new unbundled CPT code, 90... 9091...
DR. RHEUBAN: 99091 allows for unbundled CPT code for remote monitoring. Suddenly, we have a mechanism by which providers can be reimbursed to provide these services. So, that's really important. And I'm hoping that there will be more payments for practice costs--
DR. ALI: Yes.
DR. RHEUBAN: If you have to invest in technology, it's one thing to be reimbursed a relatively small amount for reviewing 30 minutes a month, but it's another for the expense of the service provided to the patient and what it takes to set it up in your own practice. So, I see that coming within the next year as well.