E-visits

The Centers for Medicare & Medicaid Services (CMS) took a small step reimbursing for technology in patient care. In its proposed 2009 physician fee schedule, CMS added three billing codes for a follow-up inpatient consultation via real-time audio and video over the Internet, or “telehealth.”

“It is significant,” says Reed Franklin, senior director of public policy for the American Telehealth Association. “We appreciate that they’re recognizing that there is a need that should be addressed.”

The telehealth codes, however, are still restrictive to only a few of doctors. CMS will only reimburse for telehealth consultations for doctors in rural areas with physician shortages or for those counties outside designated metropolitan regions. The transmission must occur in a designated site such as a hospital, doctor’s office or community clinic.

The proposed codes also do not cover telehealth follow-ups by the patient’s attending physician or for the initial consultation. If approved in the final rule, the reimbursement fee would be equivalent to a face-to-face visit for 15, 25 and 35-minute follow-up encounters.

Even though these additions are basically a reinstatement of the CPT codes which were eliminated by CMS in 2006, Franklin’s organization is encouraged by the return.

“It is definitely going to meet a patient need,” he says. “For awhile we weren’t able to have inpatient follow-up by telemedicine.”

The proposed fee schedule is open for comment until Aug. 29. A final rule will be issued in November.

In related news, the Medicare bill that halted a 10.6 percent physician reimbursement cut, which passed Congress after it overturned a presidential veto of the legislation on July 17, expanded the eligible originating sites for telehealth encounters to include skilled nursing facilities, hospital dialysis centers and community mental health centers.