Medicare Expands Service Areas for Telemedicine

The American Telemedicine Association is applauding a decision from the Centers for Medicare and Medicaid Services to expand rural coverage of telemedicine services, which CMS calls telehealth, reimbursable by Medicare.


The American Telemedicine Association is applauding a decision from the Centers for Medicare and Medicaid Services to expand rural coverage of telemedicine services, which CMS calls telehealth, reimbursable by Medicare.

CMS in a final rule setting the physician and clinical laboratory fee schedules for CY 2014 modifies its definition of Health Professional Shortage Areas to “allow for the appropriate inclusion of additional HPSAs as areas for telehealth originating sites,” according to the final rule, with comment period, available here and being published on Dec. 10.

According to the American Telemedicine Association, this means CMS expanded geographic areas where telehealth can be provided “into the fringes of metropolitan areas,” according to a statement. The association notes these other substantial changes that further support telehealth:

* Adding coverage for transitional care management services (CPT codes 99495 and 99496) and making explicit that coverage includes the Evaluation and Management portion of these services;

* Adding coverage for chronic care services (CPT codes 99487-99489) for patients with multiple chronic conditions that are expected to last at least 12 months or until the death of the patient, and that place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline, and;

* Slightly increasing the fee for originating (patient) sites from $24.43 to $24.63.

The telehealth section is on pages 536-557 and the chronic care management section is on pages 589-632.

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