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Everything You Need to Know About Telehealth Policy 2019 (1)

       

It is crucial to stay up-to-date with Telehealth policies if your practice currently offers telemedicine services, or if you are considering making the switch to telepractice.

Telehealth policy made some significant changes in 2018, and many federal and state policies passed in 2018 took effect on January 1, 2019.

We have gathered all Medicare and State policies to be aware of this new year.

MEDICARE

● Virtual check-ins, remote pre-recorded information, and inter-professional internet consultations will be now reimbursed by Medicare. Keep in mind that these services are not classified as “telehealth” and they are not subject to telehealth restriction that usually applies in Medicare such as limitations on originating sites.

● Medicare will also reimburse Rural Health Clinic (RHCs) and Federally Qualified Health Center (FQHCs) for communication-based technology and remote evaluation services that have not been captured in the RHC AIR or FQHC PPS payment, and waiving the face-to-face requirement.

● The originating site geographic requirement will no longer apply for end-stage renal disease (ESRD) services in hospital-based or Critical Access Hospital (CAH) based renal dialysis centers. And renal dialysis facilities and the patient’s home are now eligible for reimbursement for ESRD services.

● The originating geographic requirement will also not apply for diagnosis, , and treatment for acute stroke via telehealth and can take place at any eligible originating site or mobile stroke unit.

● Codes GG0513 and G0514 related to prolonged preventive services are now reimbursable by the Centers For Medicare and Medicaid Services (CMS).

● New remote physiologic monitoring codes (99453, 99454, and 99457) are now reimbursable, including new code (99491) for chronic care management.


Learn more about these new codes and requirements by referencing the Center For Connected Health Policy (CCHP) factsheet regarding the changes.

STATE POLICIES

States have also made telehealth policy changes. Check the following changes in policy at these states:

● ARIZONA: The private payer law now applies to the specialties of urology, pain medicine and substance abuse.
● ILLINOIS: Reimbursing will begin for certain mental health professionals and clinicians to provide behavioral health services via telehealth. Insurers will also be required to provide coverage for telehealth services by licensed dietitian nutritionists and certified diabetes educators who counsel senior diabetes patients in the home.
● KANSAS: Law now prohibits private payers from excluding coverage solely because a service is provided through telemedicine.
● TENNESSEE: Officially joined the Interstate Medical Licensure Compact as a new member state.
● UTAH: Law requires health benefit plans that offer coverage for mental health services to provide coverage for telepsychiatric consultations under certain conditions.

 

 


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