CMS Gives Telehealth a Nudge With Coverage for Virtual Check-Ins | mHealth Intelligence

AH_telehealth

 

Leave it up to bureaucrats to do things slowly; eventually, they get around to the right thing, despite the current occupant of the White House.

 

While much of the attention was focused on expanded reimbursement for remote patient monitoring services, an overlooked section of the 2,378-page document detailed Medicare coverage for “Brief Communication Technology-Based Service” (HCPCS code G2012). Simply put, this new code gives providers an opportunity to use telehealth to check in with their patients at certain times on care management issues.

“The new code represents a sizeable change to allow providers to efficiently use new technologies to deliver medical care,” says Nathaniel Lacktman, a partner and healthcare lawyer with Foley & Lardner who chairs the firm’s Telemedicine Industry Team and co-chairs its Digital Health Work Group. “By reimbursing for virtual check-ins, the new code exemplifies CMS’ renewed vision and desire to bring the Medicare program into the future of clinically-valid virtual care services.”

Source: CMS Gives Telehealth a Nudge With Coverage for Virtual Check-Ins

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Telemedicine’s ‘big day’ – POLITICO

AH_telehealthThe big news in the world of telemedicine is that the Centers for Medicare and Medicaid Services have finally done more than lip service to reimbursement for telemedicine services. In this world, there is an HCPCS code (“Healthcare Common Procedure Coding System,” 2018) for every conceivable service or product. Billing for both the actual visit and any imagery the helps the provider make further intervention decisions has separate codes and rates associated with them (not provided here). CMS is also finalizing policies to pay separately for new coding describing chronic care remote physiologic monitoring (CPT codes 99453, 99454, and 99457) and interprofessional internet consultation (CPT codes 99451, 99452, 99446, 99447, 99448, and 99449) (“Final Policy, Payment, and Quality Provisions Changes to the Medicare Physician Fee Schedule for Calendar Year 2019 | CMS,” 2018, pp. 4–5).

The final rules CMS released this week could advance virtual treatment further and faster than anything the government has done previously, advocates believe.

 

On Thursday, the agency finalized plans to reimburse physicians for virtually checking in with patients and remotely evaluating recorded images.

 

Thursday’s rule follows on the heels of a Wednesday CMS rule making it easier for home health agencies to get paid for remote monitoring of patients.

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Marcus Welby M.D. had it right all along

marcus_welby_intro_screenFor those too young to remember, this was an ABC series that ran from 1969-1976. Though the program had house calls as part of its outreach, this was not the main point of the series. Having said that, wise people understand what is old tends to come back as new again to a different audience. With Sen. Bernie Sanders (I-VT) announcement (PDF) of Medicare-for-all sponsored legislation being first an impetus to cover everyone with healthcare and second to do so cheaper than the current system, all opportunities to flip the current fee-for-service payment model are welcome; that is if your ox is not gored by doing so. Right now, the throwback concept of House Calls is limited to the most intensive patient care clients, as is the case with most test programs. Hey, it’s 2017, it is known what works and what doesn’t by now; let’s just get on with it.

Personally, I have a chronic leg situation that has alternating bouts of treatment. If home visits from Nurse Practitioners at a minimum and Doctor’s based on need were truly funded, the system and my condition would be greatly improved.

This is not an isolated cause, despite it being new to me. Another organization in Virginia is employing a provision of the Affordable Care Act named Independence at Home. It is a project that involves 14 practices and consortia with the closest branch being a group in Durham (NC). A team-based approach to care that involves physician assistants, pharmacists, social workers, and other staff (Daniel Farmer, 2016), I would be interested to know what the other staff is; one way it can be enhanced is the utilization of Electronic Health Records that are clean and functional.

via Bringing Back House Calls to Cut Spending on High-Risk Patients

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