The Center for Connected Health Policy has revealed a 21-page guide meant to assist providers with telehealth-based Medicare and Medicaid reimbursements.
The guide offers clarification for billing for remote patient monitoring, synchronous, asynchronous telehealth services, and billing for digital healthcare services, in addition to cell well-being services.
It focuses on commission-for-service Medicare and an example of 1 Medicaid program, California’s Medi-Cal, as a starting point—the report notes the complexity.
Medi-Cal names a “distant site” as a site where a well-being care provider who supplies well-being care service is stationed while offering these services through a telecommunications system.
The remote site for purposes of telehealth may be different from the office location.
This allows the practitioner to be in a place appropriate to telehealth encounters; however, not essentially in a clinic or center themselves, based on the California Division of Health Care Services.
For Medicare originating sites, beneficiaries must be at a location outside a city statistical space or within an outlined eligible place, with a few exceptions. At the same time, a Medi-Cal recipient might be geographically anywhere.
The report gives eight different cases through which the billing for telehealth services can fluctuate based on the type of healthcare plan and care received.
Also, the CCHP guides further methods, providers can profit through the use of telehealth components in bundled administration of care scenarios, specifically through continual care management and transitional care administration.
The report concluded that until telehealth is considered a model of care against a separate type of service, what can and cannot be billed and reimbursed would fluctuate depending on state guidelines and laws.