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It is now easier to reach out to patients and provide healthcare in their homes. Last year, the Centers for Medicare and Medicaid Services (CMS) announced the addition of new “Category 2” telemedicine services, enabling millions to avail themselves of remote health services. Not all practitioners are prepared for this shift and do not have the right tools and equipment.
Reimbursement was only given to providers for patient visits under specific conditions. In response to the COVID-19 pandemic and to accommodate the rapid shift to telemedicine, the CMS relaxed their reimbursement regulations. This allows telemedicine providers to deliver services for Medicare beneficiaries over the phone as long as video conferencing is used.
Reimbursement Variations
Telemedicine reimbursement policies differ from state to state. For instance, Alabama reimburses doctors for video conference calls for consultations, outpatient services, and psychiatric diagnostic services. Any practitioners looking to move into the telemedicine space should check their practicing state’s specific laws regarding telemedicine reimbursement.
Reimbursements may also depend on the service provider. Some companies have policies that cater to select CMS-recognized services, sites, and practitioners. Furthermore, reimbursements will be granted when proper documentation is given. The American Academy of Family Physicians (AAFP) states that documentation requirements for virtual care are similar to providing in-person care. This makes video conferencing a viable time-based documentation.
Always Check State Policy Announcements
Checking your state’s CMS regulations for specific practices before shifting your setup will avoid unnecessary expenses and secure telemedicine reimbursement. In New Jersey, the state provides reimbursement for telepsychiatry practices only. Medicare will reimburse physicians for telemedicine services at an in-person visit rate for all diagnoses and not just health concerns relating to COVID-19.
While there is no perfect system, it is important that patients can see their money’s worth in a quality telemedicine videoconference. This will reduce losses and encourage clients to return to your telemedicine business.
Kate is a Xilium writer and a former lifestyle and business assistant editor at a local Philippine newspaper. She holds a degree in pharmacy and literature, so her writing spans holistic and alternative health, medicine blog articles, and advertising and legal services. She enjoys blogging, poetry, and short fiction and has published in indie zines and anthologies.
