Telehealth 101: Medical Payment Policy and Clinical Use of Telehealth Technologies for Physicians

Course Description:
Significant expansion of telehealth in response to the COVID-19 pandemic will have a long-lasting impact on patient care and health care delivery. Medicare, Medicaid, and private payers are changing telehealth coverage and payment requirements at a dizzying pace. The effectiveness of new models of care through telehealth will determine how telehealth and telemedicine tools are used in medical practice once the COVID-19 threat is mitigated. This course explores the current and changing landscape and includes descriptions and guidance on best practices and clinical practice implementation.

Citations:
https://governor.ky.gov/attachments/20200325_Executive-
Order_2020-257_Healthy-at-Home.pdf

http://apps.sos.ky.gov/Executive/Journal/execjournal
images/2020-Reg-SB-0150-2878.pdf

Key aspects of the expansion of telehealth during the pandemic to present day include:

• Improved coverage
• Reduction of HIPAA barriers to telehealth in Medicare, Medicaid and other plans
• State licensure waiver for Medicare and Medicaid
• Access expansion including settings, services and technologies

Statement of Need:
New guidelines and compliance requirements for implementation of telemedicine may not be familiar or implementable for physicians without additional education and guidance about federal and state statute and requirements.

Objectives:
At the end of this module physicians will be able to:

• Understand Medicare’s recent changes in policy, including CPT and payment determinations, along with very recent decisions by commercial health insurers and state agencies tied to their ongoing acceptance and payment for telehealth services by physicians.
• Gain a better understanding of what are telehealth services (and telemedicine), the differences between these services from a coding and reimbursement perspective.
• Understand what is needed in order to provide these services for their patients and how to document these services in the medical record.
• Document telehealth services in the medical record for compliance.
• Describe the risks, liabilities and opportunities that this new technology and approach to patient care afford a physician practice and their patients.