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2018 Medicare PFS Final Rule Recognizes Benefits of Telehealth

Posted by The CareSync Team

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Nov 9, 2017 8:00:00 AM

The 2018 Medicare Physician Fee Schedule Final Rule has several adjustments that support the benefits of telehealth.The CY 2018 Quality Payment Program and Physician Fee Schedule sees the expansion of reimbursements for telehealth services. The move marks new recognition for the benefits of telehealth services, particularly in serving hard-to-reach, rural communities.

The Centers for Medicare and Medicaid Services (CMS) recently published a final rule impacting healthcare payments and policies for services furnished under the Medicare Physician Fee Schedule 2018.

One section of the rule specifically addresses payments for telehealth services and the expansion of existing codes to include new ones covering these telehealth services and remote patient monitoring.

These codes include:

  • HCPCS code G0506 (Care Planning for Chronic Care Management)
  • HCPCS code G0296 (visit to determine low dose computed tomography (LDCT) eligibility)
  • CPT code 90785 (Interactive Complexity)
  • CPT codes 96160 and 96161 (Health Risk Assessment)
  • CPT codes 90839 and 90840 (Psychotherapy for Crisis)

CMS interest in telehealth appears to stem from feedback of healthcare providers that previous approaches to telehealth payments and policy were “overly broad and not always reflective of current technology.” The goals of the updates appear to be making it easier and more appealing for providers and their patients to actively enjoy the benefits of telehealth and remote patient monitoring.

Doctor having phone call in medical office.jpegThe benefits of telehealth will include expanded opportunities for Medicare reimbursements.

A CMS statement added, "We believe that the use of digital technologies that provide either one-way or two-way data between MIPS eligible clinicians and patients is valuable, including for the purposes of promoting patient self-management, enabling remote monitoring, and detecting early indicators of treatment failure.”

Health systems have already been sharing positive benefits of telehealth. It’s a key opportunity to expand quality care to those populations that are geographically isolated or at a disadvantage either economically or medically.

For instance, Federally Qualified Health Centers (FQHC) or Rural Health Clinics (RHC) are able to leverage the benefits of telehealth and other health technology, particularly mobile health tools, to reach underserved populations throughout hard-to-reach, rural communities. This extends the physician’s reach and opens opportunity for improved patient care throughout the year.

A 2017 report, “Anticipating Economic Returns of Rural Telehealth,” examines the potential benefits of telehealth for FQHCs and RHCs from a financial standpoint. The report states that 15% of the nation’s population lives in rural areas, but only 10% of providers practice and serve rural communities. Rural healthcare settings could save up to $81,000 annually through use of telehealth services. Alaska, Texas, and California were among the states identified with most potential cost savings related to benefits of telehealth adoption.

The benefits of telehealth and digital health tool, such as mobile health apps, will become more widely recognized in 2018 as they are poised to become a top health technology trend.

Reimbursements are also available for use of digital health tools and health technology through implementation of a new improvement activity performance category with higher weight. Providers who collect patient health data through digital platforms that is communicated back to care teams can receive benefits under this policy. 

Want answers to frequently asked questions about Medicare's Chronic Care Management (CCM)? Click here for a complete resource for Chronic Care Management answers.

Codified care coordination makes it more feasible for physicians to be adequately rewarded for increasing value of care through between-visit service.

It’s a positive step for not only adoption of digital health and telehealth services, but also value-based care and Chronic Care Management in general.

To learn more about the benefits of adding Chronic Care Management to your practice, or to discuss the ways we can support FQHCs and RHCs in meeting new care coordination requirements for 2018, contact CareSync at 1-800-501-2984 or sales@caresync.com.


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