Telemedicine Pays: Billing and Coding Update
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TELEMEDICINE AND TECHNOLOGY (J PORTNOY, SECTION EDITOR)
Telemedicine Pays: Billing and Coding Update Sakina S. Bajowala 1
&
Jacob Milosch 1 & Chandani Bansal 2
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review Telemedicine is a rapidly growing healthcare sector that can improve access to care for underserved populations and offer flexibility and convenience to patients and clinicians alike. However, uncertainty about insurance coverage and reimbursement policies for telemedicine has historically been a major barrier to adoption, especially among physicians in private practice (the majority of practicing allergists). Recent Findings The COVID-19 public health emergency has highlighted the importance of telehealth as a safe and effective healthcare delivery model, with governments and payers rapidly expanding coverage and payment in an effort to ensure public access to healthcare in the midst of an infectious pandemic. This comprehensive review of updated telemedicine coverage and payment policies will include a tabular guide on how to appropriately bill and optimize reimbursement for telemedicine services. Summary This review of current trends in telemedicine coverage, billing, and reimbursement will outline the historical and current state of telemedicine payment policies in the USA, with special focus on recent policy changes implemented in light of COVID-19. The authors will also explore the potential future landscape of telehealth coverage and reimbursement beyond the resolution of the public health emergency. Keywords Telemedicine . Telehealth expansion . Payment parity . COVID-19 . Telemedicine billing . Reimbursement
Introduction Telemedicine refers to the remote evaluation and treatment of patients using telecommunications technology. Initially envisioned in the 1920s as a virtual alternative to a physician’s house call, the technology needed to practically implement telemedicine was not developed until mid-century, when NASA needed a way to provide medical care to astronauts in space. The ambitions of telemedicine returned back to earth in subsequent decades, linking hospitals to airports in the 1960’s, delivering healthcare to Indian reservations in the 1970’s, providing healthcare support to Armenia in the wake of an earthquake in the 1980’s, and being introduced by Medicare as a way to deliver medical care to underserved rural This article is part of the Topical Collection on Telemedicine and Technology * Sakina S. Bajowala [email protected] 1
Kaneland Allergy and Asthma Center, 1213 Oak St., North Aurora, IL 60542, USA
2
University of Texas at Austin, Austin, TX, USA
populations in the 1990’s [1, 2]. Over the next two decades, telemedicine extended its reach beyond remote and underserved patients, to include after-hours care, walk-in urgent visits, remote physiologic monitoring, chronic care management, and routine evaluation and management services for the general population.
Impact of Reimbursement Limitations on Telemedicine A
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