Page 14 - Part 1 Introduction to Telemedicine

SVMIC Introduction to Telemedicine

Financial Definitions

After liability, the most pragmatic interest of providers and facilities

is how they can be reimbursed by payers. The definitional issue for
payment is not what constitutes telemedicine as a whole, but

rather, the descriptions of specific procedures and services that
can be recognized as claims by an adjudication system.

CPT and HCPCS codes for telehealth services eligible for Medicare

reimbursement are enumerated in several publications (including
https://www.cms.gov/Outreach-and-Education/Medicare-

Learning-Network-

MLN/MLNProducts/downloads/TelehealthSrvcsfctsht.pdf). Of
course, State Medicaid and private payers march to their own

drummers, as do the DOD and VA.

Understanding and complying with the terms for coding and

reimbursement for each payer is a well-known art form. It is

important to recognize that describing items eligible for payment is

a completely different matter from defining “telemedicine” or

“telehealth” for legal or regulatory purposes.

Telehealth, eHealth or mHealth?

The term telehealth often appears alongside telemedicine. Some

authorities prefer one or the other, and there is currently no

standard for reconciling them. Except when they appear explicitly

in statutes, regulations or contracts, telemedicine and telehealth
are usually interchangeable. According to the ATA:

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