The benefits of telemedicine are becoming more evident as the trend evolves. We are starting to see a rise in patient engagement and a decrease in abandoned and rescheduled follow-up appointments. The convenience provided to our patients is creating a more beneficial doctor-patient relationship, leading to ultimately better patient care.
With health insurance companies beginning to offer coverage for a majority of telehealth services, patients are beginning to utilize these options in greater capacity.
But what about those on Medicare and Medicaid? As this article is written, there are close to 137 million Americans on Medicare and Medicaid. Are they finding the benefits of telemedicine to be as advantageous as their peers with private insurance?
Are services covered by private health insurance companies also covered by Medicare and Medicaid?
Options for Medicare and Medicaid Patients
With each state having its own set of rules and regulations regarding coverage for telemedicine, we cannot have one single answer for what is covered and what is not. For instance, in some states, Medicaid and Medicare will only cover virtual visits for patients who are located in rural areas or within a certain distance from an office or clinic.
Conversely, many states minimize restrictions and require only that a doctor and a patient follow typical guidelines that would need to be followed with in-person visits. Examples of this would be delivering a covered health service or doing the visit from an eligible originating date.
Some states even allow coverage for virtual visits performed by a staff member other than yourself, such as Nurse Visits. This is a trend we hope to see progress.
Reimbursement for Telemedicine
Billing guidelines for telemedicine vary from state to state, just as specific coverages vary by state, but most states have adopted a similar method for both Medicare and Medicaid. This process would begin by first confirming that the procedure or visit is covered. Then, when billing, you would simply select the appropriate CPT/HCPCS code along with your GT modifier to indicate the service was completed via telemedicine.
How much will you be reimbursed for the virtual visit? Most Medicaid visits are paid at the same rate as an in-person visit. So if you would bill a standard 99213 E&M code for an in-person visit, you can bill 99213 for an e-visit and be reimbursed the same. This is why we are such advocates for sharing the knowledge of the benefits of telemedicine for providers as well as their patients.
Looking for More Information on the Benefits of Telemedicine for Physicians?
The telemedicine business was a $38 billion business in 2018. Experts are expecting this trend to continue on an incline with a compound annual growth rate (CAGR) of 19% from 2019 until 2025.
Curious as to how you and your practice can capitalize on the benefits of telemedicine? Attending a Physicians Gone Wild retreat will give you the tools you need to hit the ground running…not until you return to the office, of course. These retreats take place in exotic destinations and all sessions are over by noon, giving you plenty of time to dig your toes in the sand or go exploring!
Contact us today for more information: firstname.lastname@example.org