Page 15 - Telemedicine - Essentials of Virtual Care Delivery Part One

SVMIC Telemedicine: Essentials of Virtual Care Delivery

Criminal liability may arise from violating licensing or other laws;

but, exposures to civil liability (i.e., malpractice) that come with
the practice of medicine are not canceled when the practice

happens at a distance—in fact, some may be amplified. A more
detailed discussion of professional liability follows in a later

section.

Financial Definitions

CPT and HCPCS codes for telehealth services eligible
for Medicare reimbursement are enumerated in several

publications and are changing regularly. Of course, State
9
Medicaid and private payors march to their own drummers,

as do other government payors. Additionally, there may be
significant variation in coverage among payors for similar codes.

For instance, payors in some states may provide coverage for
audio-only visits, while other payors may require live audio and

video communication. Providers and their practices need to be
familiar with the often-changing requirements and criteria for

covered telemedicine visits.

Understanding and complying with the terms for coding

and reimbursement for each payor 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.

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:

9 https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/
MLNProducts/downloads/TelehealthSrvcsfctsht.pdf

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