Update of Telemedicine and eClinicalWorks® Medical Billing for CMS

Is your practice considering adding telemedicine to your services? EMR Billing Solutions dedicates themselves to improving your practice’s patient and revenue goals through eClinicalWorks(R) medical billing, and telemedicine might be a viable path for some.

While telemedicine is not a distinct service, according to the Medicaid statute, there are now several more HCPCS codes, CPT codes, and modifiers for you to use. Individual states can choose to allow or disallow telemedicine, and can decide how, where, or with whom it is practiced, so check with your billing specialist for specifics.

According to Medicaid.gov’s Delivery Systems Content for Telemedicine, “For purposes of Medicaid, telemedicine seeks to improve a patient’s health by permitting two-way, real time interactive communication between the patient, and the physician or practitioner at the distant site. This electronic communication means the use of interactive telecommunications equipment that includes, at a minimum, audio and video equipment.” In every telemedical situation, there is an originating site (where the patient is during the consultation), and a distant site (the location of the licensed practitioner – physician, nurse practitioner, physician assistant, nurse midwife, etc.). Linkage of the two sites must occur during the consultation in a manner that allows the patient and the licensed practitioner to see and speak to each other without any delays.

The allowable telehealth codes, found on a Medicare Learning Network Health Fact Sheet for Telehealth Services, cover a fairly broad range of services. According to an American Telemedicine Association (ATA) article, Update on CMS Payment Decisions – Two Steps Forward, One Back, in 2015 the Centers for Medicaid and Medicare (CMS) added to telehealth coverage, beginning to “reimburse, as a telehealth service, seven new covered services for telehealth including annual wellness visits, psychotherapy services, and prolonged services in the office.” These new codes also include two that allow for collection, interpretation, and analysis of data. While the ATA wishes CMS had included more services, it is a step in the right direction, and advocates push for new additions yearly.

Billing for telemedicine can complicate the process, as payment might be split between the originating site and the distant site, but help is available with services such as EMR Billing Solutions’ Billing Service PLUS, which handles all patient-related billing inquiries. This leaves you free to focus on your patients.

As we head into a future with more and more consumer technology capable of monitoring health away from a Doctor’s office, it is good to know the insurance field is moving forward, as well.