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Author: mstewart

As Telemedicine Soars, Reimbursement for Telemedicine Services Slowly Evolve

The use of telemedicine has soared in recent years, as new technologies develop and consumer demand for instant access to healthcare increases.  Indeed, the telemedicine market is expected to grow to $113.1 billion by 2025, at an estimated compound annual growth rate of 18.8%.  It is expected that at least 7 million patients in the U.S. will access telemedicine services in 2018, a sharp increase from 2013, when the estimated number of telehealth patients was less than 350,000.  Despite this momentous growth, reimbursement continues to be a key obstacle for telemedicine providers.  However, reimbursement rules by various payors are slowly expanding to cover more telemedicine services. Medicare remains one of the most restrictive payors for telemedicine services, with exceptionally limiting reimbursement rules.  With some exceptions, Medicare will pay for a telemedicine encounter only when the patient is located in a rural area and present at an eligible originating site, the service must be delivered by one of 8 eligible professionals, and the modality must be real-time, interactive, and face-to-face (thus prohibiting “store and forward” telemedicine technologies), with a limited number of available codes.  Notably, Medicare recently changed its coding for telemedicine services, eliminating use of the “GT” modifier traditionally used to indicate that the service was provided via telemedicine; in its place, Medicare has created Place of Service Code 2, which should be used in the place of the...

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Telehealth Resource Centers Are an Invaluable Resource for Providers Developing Telemedicine Programs

As information spreads regarding the many benefits to telemedicine, health care providers wanting to adopt a telemedicine program face a daunting web of complex questions: Which telehealth services are best suited to my patient’s and practice’s needs? What technology equipment should be purchased? Which vendor should I use? And how can I secure reimbursement? Although setting up a telemedicine practice can appear to be overwhelming, providers in every state have access to a valuable resource that can help them answer these important questions and many others, at no cost: their Regional Telehealth Resource Center. The Regional Telehealth Resource Center Program consists of 12 regional and two national telehealth resource centers designed to provide “assistance, education and information to organizations and individuals who are actively providing or interested in providing medical care at a distance.” The Centers are funded by grants from the U.S. Department of Health and Human Services’ Health Resources and Services Administration Office for the Advancement of Telehealth; as a result, their services are generally free of charge. Each of the 12 Regional Telehealth Resource Centers possess regional expertise to assist local providers with the unique telemedicine issues and regulations affecting that region. Two additional national centers, including the Center for Connected Health Policy and the National Telehealth Technology Assessment Resource Center, focus on areas of technology assessment and telehealth policy. Collectively, “the TRCs participate as a...

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The Health Law Blog is published by Dickinson Wright PLLC to inform the public of important developments within the firm and practice areas. The content is informational only and does not constitute legal or professional advice. We encourage you to consult a Dickinson Wright attorney if you have specific questions or concerns relating to any of the topics covered in this blog.