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CMS Expands Telehealth Reimbursement with New Rule, Says ATA

November 3, 2014
by Gabriel Perna
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Buried within a 1,185 page rule from the Centers for Medicare and Medicaid Services (CMS) on payments to physicians is an indication that the agency is expanding reimbursement for telemedicine.

The rule included were provisions paying for remote chronic care management using a new current procedural terminology (CPT) code, 99490, with a monthly unadjusted, non-facility fee of $42.60, said the American Telemedicine Association (ATA). CMS also said it will pay for remote-patient monitoring of chronic conditions with a monthly unadjusted, non-facility fee of $56.92 using CPT code 99091. Before this, CMS did not pay separately for services and required that it bundled with an “evaluation and management” code.

CMS also added seven new procedure codes for telehealth, including annual wellness visits, psychotherapy services, and prolonged services in the office.

“It has been a long time coming, but this rulemaking signals a clear and bold step in the right direction for Medicare,” stated ATA CEO, Jonathan Linkous. “This allows providers to use telemedicine technology to improve the cost and quality of healthcare delivery.”

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This is fantastic news, and a long time coming. I am happy our government understands the value add that telehealth and telemedicine bring and the additional reimbursement codes will encourage innovations.


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