Health IT, Hospitals, Policy

New CMS guidelines on telemedicine reimbursement include ‘significant additional coverage’

As CMS goes, so goes private insurance. That’s perhaps a simplification of how reimbursement rates […]

As CMS goes, so goes private insurance. That’s perhaps a simplification of how reimbursement rates are developed for healthcare payers, but big payers definitely watch what CMS is doing.

So it’s no small deal that CMS late last week issued new rules that include “significant additional coverage for telemedicine services,” the American Telemedicine Association said in a release.

Buried in an almost 1200-page document for 2015 Medicare payments to physicians and practitioners were provisions paying for remote chronic care management using a new current procedural terminology.

In addition, Medicare will cover remote-patient monitoring of chronic conditions. Previously, Medicare didn’t pay for separately for such services, requiring that such billing be bundled with an “evaluation and management” code,” according to the ATA.

Also covered in 20105 are seven new procedures for telehealth, among them: annual wellness visits, psychotherapy services and prolonged services in the office, and others.

“It has been a long time coming, but this rulemaking signals a clear and bold step in the right direction for Medicare,” said Jonathan Linkous, CEO of the ATA, in a statement. “This allows providers to use telemedicine technology to improve the cost and quality of healthcare delivery.”

Last week, in a positive step for coverage of telehealth, Iagnosis and Highmark Commercial Insurance, a Blue Cross Blue Shield-affiliated carrier in Pittsburgh, announced that telemedicine visits would be a covered benefit for some 5.2 million members across Pennsylvania, West Virginia and Delaware.

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