CMS hints at more telemed payment
The Centers for Medicare & Medicaid Services (CMS) is considering paying primary care physicians for chronic care management services without an in-person visit, and also for telehealth services. Keep a close tab on how this proposal fares as you work to avoid fraud and abuse issues with telemedicine.
CMS proposed the improved payment in the Medicare Physician Fee Schedule for 2014 and suggested a change that would start in 2015. Under the CMS proposal, patients would need to have an annual, in-person wellness visit and consent to a doctor’s management plan for a year.
To make telehealth reimbursement possible, the proposal redefines the definition of "rural" to avoid disruption of services if an area’s geographic designation is changed. CMS said in the proposal that it is looking for evidence that "the service furnished by telehealth to a Medicare beneficiary improves the diagnosis or treatment of an illness or injury" or that it improves patient functioning.
CMS would reimburse for telehealth only if it is provided by one of eight kinds of healthcare professionals. Additionally, only certain kinds of codes are eligible, mostly involving screening and mental healthcare.