Telemedicine: Reimbursement Update

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  • Published date: March 3, 2020
    • Fremont, California, United States

Under the Social Security Act, reimbursement for telehealth under Medicare has been subject to stringent restrictions.

Only patients in certain identified practice settings in rural, physician-underserved areas were eligible. Care into the patient's home was not covered.

Only certain providers were eligible. With rare exceptions (demonstration sites in Hawaii and Alaska), only real-time, audio-video communications were eligible. And, only a rather modest number of CPT codes were eligible. These provisions are still good law. In 2015, however, the first modification of these rules appeared, allowing reimbursement, still subject to extensive restrictions, for chronic care management. Because a co-pay had to be charged, patient consent was required, for services that the patient had previously received at no charge.

Roger Steven
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