CMS physician fee schedule outlines new telehealth service regions

The Centers for Medicare & Medicaid Services has announced changes to Medicare's 2014 physician fee schedule to expand coverage for telehealth services.

"The proposed new rules, while incremental, represent another step toward integrating the use of telecommunications technology into the delivery of healthcare," Jonathan D. Linkous, chief executive officer of the American Telemedicine Association (ATA), said in an announcement.

The proposed rules, published in the Federal Register, change service areas from strictly-defined rural areas to "into the fringes of metropolitan areas," as the ATA put it.

They add coverage for chronic care services for patients with multiple chronic conditions and slightly increase reimbursement for physicians to $24.63 from $24.43. The ATA has been lobbying for the change, arguing that "hundreds of thousands" of Medicare beneficiaries could lose services with updates to federal urban/rural categorizations.

It says 80 percent of Medicare beneficiaries live in metropolitan areas where telehealth services are not covered.

Since CMS published the proposed fee schedule last summer, it has received comments from rural clinics concerned that they would be excluded from reimbursement based on the way the geographic coverage areas are determined. Others have said that determining geographic eligibility may be so complex that it can deter providers from participating, reports Government Health IT.

Sixty-four organizations and businesses have lined up behind the TELEhealth for MEDicare (TELE-MED) Act of 2013, which would allow Medicare providers to treat patients electronically across state lines without having to obtain multiple state medical licenses.

And a bill aimed at boosting telehealth use to reduce hospital readmissions for Medicare beneficiaries in rural and underserved areas was reintroduced to Congress in March.

A bill introduced in the House in November would expand reimbursement for telehealth services for active-duty military, retired veterans and their dependents. The ATA has called government a "lagging partner" to telehealth, erecting barriers to adoption for two decades.

To learn more:
- read the proposed rules, starting on page 536 (.pdf)
- find the ATA announcement
- here's the Government Health IT article

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