Thursday, December 5, 2013

Medicare Physician Fee Schedule Expands Telehealth Coverage

CMS' recently released finalized Medicare Physician Fee Schedule for 2014 includes expanded coverage for telehealth services and increased reimbursement payments for such services, MedPage Today reports (Pittman, MedPage Today, 11/27).


In July, CMS proposed a policy change that would expand payments for telehealth services under the Medicare Physician Fee Schedule for 2014.
The agency said it was seeking evidence to "demonstrate the service furnished by telehealth to a Medicare beneficiary improves the diagnosis or treatment of an illness or injury" or boosts patient function (iHealthBeat, 7/9).

Details of Telehealth Rules

Under the finalized fee schedule, Medicare coverage for telehealth services will be expanded to rural areas as defined by the Office of Rural Health Policy.
The American Telemedicine Association says the new language will expand Medicare coverage of telehealth into the "fringes of metropolitan areas."
In addition, telehealth reimbursement rates for originating patient sites will increase from $24.43 to $24.63.
However, CMS said it does not have the authority to "waive the geographic telehealth requirements" for rural health clinics "that do not meet any of the requirements to serve as an originating site."
CMS officials said the agency is working with the Health Resources Services Administration to create a website to help providers determine their eligibility to serve as an originating site for telehealth services (Brino, Government Health IT, 12/3).
CMS will publish the final rule on Dec. 10 (Herman, Becker's Hospital Review, 12/2).

ATA's Response

In a release, ATA called the telehealth provisions in the fee schedule "good news."
ATA CEO Jonathan Linkous said, "The proposed new rules, while incremental, represent another step toward integrating the use of telecommunications technology into the delivery of health care" (ATA release, 11/30).

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