Page 35 - Telemedicine - Essentials of Virtual Care Delivery Part Two

SVMIC Telemedicine: Essentials of Virtual Care Delivery

single, per visit fee, and some created more complex tables of

services and payments, including patient incentives in the form
of reduced co-payments.

As technology and employer benefits make telemedicine more

accessible for patients and providers, the level of comfort on
both sides of the telemedicine visit should increase, particularly

with a provider familiar to the patient.

While many private payors have implemented or are considering

implementing payment mechanisms for telemedicine under
many different models, the example of Medicare serves to

illustrate some of the variables in play.

Medicare (CMS) frequently changes its coverage policies.
Providers need to study and frequently update their knowledge

of telemedicine coding and reimbursement.

Prior to the pandemic, Medicare reimbursed only for specific

services when delivered via live video. Store-and-forward
services were not eligible. During the emergency declaration

(still in effect as of this writing), CMS reimbursed for certain
audio-only care.

The specific telehealth services eligible for reimbursement

under Medicare are identified by Current Procedural
Terminology (CPT) or Healthcare Common Procedure Coding

System (HCPCS) codes. Each year, the US Department of
Health and Human Services considers submissions for new

telehealth-delivered services to be approved. CMS maintains a
list of current CPT codes eligible for Medicare reimbursement.
11

11 https://www.cchpca.org/telehealth-policy/current-state-laws-and-reimbursement-policies#
[7/16/18]

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