CCHP Unveils Telehealth Reimbursement Guide for Providers

The Center for Connected Health Policy has unveiled a telehealth billing guide, aimed at helping healthcare providers navigate the confusing waters of connected health reimbursement.

With roughly three-quarters of the nation’s hospitals and health systems now using telemedicine or mHealth technology, “it is not surprising then that the question of billing is the foremost question heard by telehealth resource centers, followed by ‘will I get paid?’” CCHP officials point out in their 21-page resource guide. And because reimbursement isn’t guaranteed for any specific service, it’s on the provider to navigate a path to payment.

Telehealth reimbursement consistently ranks as one the largest barriers to adoption, thanks in part to restrictions placed on Medicare coverage by the Centers for Medicare & Medicaid Services, different protocols for Medicaid coverage in each state and varying policies among private payers. The CCHP guide focuses primarily on fee-for-service Medicare rules and Medicaid policies, as seen in California’s Medi-Cal program.

Topics covered include billing for asynchronous (store-and-forward) and synchronous (real-time audio-visual) telehealth, including defining originating and distant sites; billing for virtual healthcare services, including remote patient monitoring, virtual check-ins, eConsults and eVisits; mHealth coverage and differences in reimbursement for practice types.

In addition, the guide offers eight examples of common telehealth or mHealth cases and the coding procedures needed to qualify for reimbursement.

The guide is one of many resources offered by the California-based CCHP, one of a network of 12 regional and two national Telehealth Resource Centers.