Benefits
Frequently Asked Questions
What is TeleHealth?
What Financial Benefits does TeleHealth offer?
CMS has proposed three new code sets for services to be covered under specific conditions
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Virtual Check-Ins, officially titled “Brief Communication Technology-Based Service" -
Asynchronous Images and Video, officially titled “Remote Evaluation of Pre-Recorded Patient Information” -
Peer-to-Peer Internet Consults, officially titled “Interprofessional Internet Consultation.
Virtual Check-Ins / Brief Communication Technology-Based Service
Virtual check-ins are defined by a physician (or other qualified health care professional who can report evaluation and management services) digitally interacting for 5-10 minutes (telephone interactions or audio interactions enhanced with video) with an established patient.
How will Asynchronous Visits be Supported?
Asynchronous telemedicine is efficient, patient-centered, and aligns with how many service providers deliver non-healthcare and online services today.
CMS’ coverage of these services sends a strong message, both to medical boards and commercial health plans, that asynchronous telemedicine is an important and clinically-valid tool through which providers can deliver healthcare services.
The new code, HCPCS GRAS1, for “Remote Evaluation of Pre-Recorded Patient Information,” which would reimburse for a provider’s asynchronous review of “recorded video and/or images captured by a patient in order to evaluate the patient’s condition” and determine whether or not an office visit is necessary.
This type of review is also referred to as “store-and-forward” communication technology.
About Peer-to-Peer Internet Consults
Are there any Limitations?
- Frequency Limitations - CMS did not propose to impose a frequency limit on the use of virtual check-ins by the same practitioner with the same patient.
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Timeframe Limitations - Under the proposed virtual check-in code, CMS would reimburse providers for “5-10 minutes of medical discussion” so long as an E/M was not provided within the previous seven days.
Additionally, in order for the code to apply, the virtual check-in appointment must not lead to an E/M or procedure within 24 hours of the appointment or soonest available appointment.
This is similar to how CMS views coverage of telephone consults, and the AMA has historically advocated for separate coverage and reimbursement for telephone consults.
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Other Limitations - None of these codes require the use of interactive audio-video technology, nor do they require the patient be located in a rural area or a specific qualifying originating site.
Moreover, CMS’ proposal to cover asynchronous telemedicine and non-face-to-face services is a major recognition of the validity of asynchronous telemedicine (also known as store-and-forward medical care without the use of interactive audio-video or a face-to-face exam).
Use Cases
PCP
Provide Ongoing Care
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Diabetes -
Hypertension -
Coronary artery disease -
Cardiac arrhythmia -
End-stage renal disease -
Hepatitis -
Asthma / COPD -
Obesity -
Oncologic co-morbicities -
Neurodegenerative diseases
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Colonoscopy / sigmoidoscopy results -
Mammogram results -
Cholesterol levels -
STD testing -
CBC results -
Blood glucose levels -
Liver function testing -
Pap smear results -
Blood electrolytes
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Cold and flu -
Allergies -
Sinus/ear infections -
Sore throat -
UTIs -
Diarrhea and vomiting
OBGYN
Manage Medications
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Postpartum Depression - Offering convenient access for women suffering postpartum depression is an essential part of providing perinatal care as an OB/GYN. Use telemedicine to frequently check in with patients suffering from depression and ease the burden of travel on these new mothers. Even for women who aren't suffering from postpartum right away, remote video appointments are an ideal way to monitor if such a condition develops during the weeks following childbirth.
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Gestational Diabetes - Once a woman is diagnosed with gestational diabetes, special meals plans, scheduled physical activity, and even daily insulin self-checks are essential for effectively managing the condition. Checking in with your patients, even as often as weekly, is necessary to understand the progression of diabetes and the effectiveness of the individual treatment plan. Instead of checking in with a non-reimbursable phone call, schedule weekly or semi-monthly telemedicine appointments to keep tabs on your patients suffering from gestational diabetes.
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Hypertension and PreeClampsia - Although in-person physical exams are often necessary to monitor the progression of hypertension to preeclampsia, frequent check-ups to discuss symptoms (such as headache, blurred vision, or sensitivity to light) can be done effectively over telemedicine. It also allows OB/GYNs to offer patients face-to-face interactions should sudden issues or concerns arise.
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Follow-up on Well Woman Exams - While annual Well Woman exams require a head-to-toe physical exam, following up on blood work and other screenings is ideal for a remote telemedicine visit. These remote visits also give OB/GYNs the opportunity to discuss how the patient can make smart lifestyle decisions in order to improve overall health – which is especially important when abnormal results are found.
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Family Planning and Preconception Care - Whether you’re managing birth control doses for patients not yet wanting to have children or assisting a couple that’s ready, telemedicine can be used for ongoing counseling, modifying lifestyle treatment plans, and adjusting hormone-based medications.
Neurology
Medication Management
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Neuropathy - Treating Neuropathy typically involves managing symptoms. Lifestyle counseling to help limit the disease progression and adjusting medications like antidepressants, antiepileptics and cannabis can all be done over telemedicine.
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Epilepsy - Although about 70% of cases can be controlled through medication, frequent in-office lab work is still necessary. Using telemedicine to adjust medications, discuss symptom progression, and the review of diagnostic imaging results and blood work helps minimize trips to the office for epileptic patients.
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Parkinson's Disease - Once someone is diagnosed with Parkinson’s disease, therapies involving the use of Levodopa or dopamine agonsists to help control motor function can be managed through telemedicine. Although in-person rehabilitation is required, neurologists can also use telemedicine to counsel patients on dietary changes, exercise adjustments, and palliative care.
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Multiple Sclerosis - Because many medications such as corticosteroids, interferons, and pro-/anti-inflammatory can cause serious side effects, frequently monitoring their progression is essential and can be done effectively over telemedicine. Additionally, reviewing liver and blood tests or offering emotional counseling can also be done through telemedicine without losing the face-to-face interaction patients desire.