More telehealth makes the cut for Medicare coverage next year

By Aditi Pai
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A state-side example of video comms with MDs: Verizon Wireless Virtual Visits

Earlier this week, the Centers for Medicare and Medicaid Services (CMS) released its final rule that will lead to changes in coverage under Medicare Part B. The rule, proposed in July, will expand the range of telehealth services that can be reimbursed under Medicare starting in 2015.

In July, MobiHealthNews noted in the new rule, CMS added seven new telehealth reimbursement codes, all category 1, that fit into three general areas.

CMS added telemedicine codes for an “annual wellness visit” including a personalized prevention plan of service — one code for the initial visit and another for subsequent visits.

In the area of mental healthcare, CMS has added codes for psychoanalysis and family psychotherapy (which has two codes, one for family therapy with the patient present and one for family therapy with the patient absent). The next two codes are ones that therapists use to report sessions that go overtime or require additional time over the scheduled hour-long visit — these will now be eligible for reimbursement via telehealth. 

"If you look at our last payment rule that was out October 31st, look at telemedicine," CMS Principal Deputy Administrator Andy Slavitt said at the Digital Healthcare Innovation Summit in Boston, Massachusetts. "We have broadly expanded what we’ll pay for — we'll pay for preventive, we’ll pay for checkups, we’ll pay for a bunch of new things in telemedicine, particularly to drive access in rural communities. These are things I wouldn’t have known, but it’s useful for everybody to look at payment rules when CMS issues them and see, because I think it shows the evidence that has been acted upon."

Slavitt added that the time CMS is allowed to make weigh the decisions on these rules is shorter than he would prefer. CMS needs to cover a lot of ground when making changes to these rules.

"The thing that I am also aware of is every one of those decisions matters a hell of a lot," he said. "Some of them matter a hell of a lot to 50 people who have a really difficult to cure disease and some of them matter a lot to people who have an access issue. But everything that comes up, comes up because it matters to somebody, and because people are desperately trying to improve their quality of life."

Slavitt also explained that the Center for Medicare & Medicaid Innovation (CMMI) is working on offering grants and acting as a catalyst for building new technologies.

"The inclination from us to try to do it ourselves, build the technology ourselves, or to issue a grant and hope that someone makes some big new technology because they’ve got a grant," he said. "I think that’s a fool's errand. I think we’ve got to set a course for what we think we need, whether it's bundled payments or any other kind of new technology and hope the people can look at that and say 'Yeah we can do that'."