CMS Proposes Rule to Expand Telehealth Payments

Wellness and behavioral health visits are among a few telehealth coverage expansions the Centers for Medicare & Medicaid Services (CMS) wants to add to the list of Medicare reimbursable telehealth activities under a proposal released Thursday last week. Providers also would be paid for telehealth services in rural areas nearer big cities under a geographical expansion in the proposed rule.

The 609-page proposed rule principally deals with annual changes to polices under the Medicare Physician Fee Schedule, including eliminating the exclusion for continuing medication education (CME) under the Sunshine Act that requires drug companies and medical device makers to disclose payments to physicians.
Added to the list of covered telehealth services by the proposal are annual wellness visits, both for an initial visit, and for subsequent visits, if they include a personalized prevention plan of service. 

Read the article in Modern Healthcare here (requires a free subscription).

A June 27th article in Insurancenewsnet.com discusses four major barriers to telehealth adoption. Read the article here, which includes an interview with Ed Bostick, Executive Director of the Colorado Telehealth Network.

Medicare Expands Definition of Rural for Telehealth

Effective January 1st, the Centers for Medicare and Medicaid Services (CMS) expanded the definition of “originating sites” to include Health Professional Shortage Areas (HPSAs) that are located in rural census tracts of Metropolitan Statistical Areas. Also, as part of the update to the Physician Fee Schedule for 2014, Medicare added “Transitional Care Management Services” to the list of codes eligible for payment when provided via telehealth.

Medicare defines “originating site” as the location of an eligible Medicare beneficiary at the time the service is provided via telemedicine. To find out if an authorized originating site is eligible for Medicare telehealth payment, check out the new payment eligibility analyzer from the Health Resources and Services Administration. Check out the tool here.