2018 Telemedicine: Coding, Billing and Compliance

Get Insights on Medicare updates for Telemedicine Regulations in 2018

Telemedicine services have been seeing a continuous growth both in terms of volume and breadth of coverage. Hospitals large and small participate in telemedicine services although in different capacities. Making certain that all the rules and regulations are faithfully followed can be challenging.

Most of the guidance for telemedicine or telehealth services comes from the Medicare program. However, changes in the guidance occur almost every year. While the Medicare program has many rules and regulations in this area, private third-party payers tend to be more liberal in reimbursing for these types of services. The recently enacted 21^st Century Cures Act directs CMS to expand telemedicine services. Remote robotic surgery is on the horizon. Hospitals, clinics and physician must regularly update policies and procedures in this area to keep current as the technology continues to outstrip payment and compliance issues.

Join this session, where healthcare consultant Duane C. Abbey, Ph.D., will provide an overview of the general concept of how telemedicine works. Duane will discuss how you can assess future changes for telemedicine, particularly with Medicare.

Session Objectives

This session will help you understand:

• The general concept of telemedicine and how it works
• The underlying technology and advancements that allow telemedicine services to work
• The special terminology used in telemedicine
• The current Medicare rules and regulations surrounding telemedicine services
• The special requirements for physicians and practitioners
• How to code, bill and the reimbursement process for telemedicine services under the Medicare program
• The clinical and billing privileges surrounding telemedicine
• The changes in credentialing for physicians providing telehealth services
• The changes in coverage and types of services that can be provided through telemedicine
• How to assess unusual requirements for different providers relative to telemedicine services
• How private third-party payers view telemedicine
• The 21^st Century Cures Act relative to telemedicine
• How to assess future changes for telemedicine particularly with Medicare

Session Highlights

This session will discuss:

• How telemedicine is supposed to work
• Why the terminology is so confusing
• What the difference between telemedicine and telehealth is
• Who is involved in telemedicine
• Who is allowed to provide telemedicine services
• How telemedicine services are paid under the Medicare program
• What hospitals, CAHs and clinics need to do in order to bill for telemedicine services
• Is there anything special about rural health clinics (RHCs)
• Any compliance issues for telemedicine
• How private third-party payers view telemedicine and telehealth services
• How the 21^st Century Cures Act will impact telemedicine and telehealth

Session Agenda

This session will cover:

• Overview
  • Telemedicine services
  • Telehealth services
  • General process
  • Review of terminology
  • Current legislation – 21^st Century Cures Act
• Underlying technologies
  • Interactive communications
  • Electronic monitoring
  • Remote robotic services
• Clinical issues for telemedicine
  • Physicians
  • Non-physician practitioners
  • Consultation services
• Updating telemedicine
  • What services can be provided?
  • Who can provide services?
  • Where can services be provided?
  • New place-of-service (POS) code
• Coding, billing and reimbursement issues
  • Coding and claims filing requirements
  • Special codes and modifiers
  • Distant site consideration
  • Originating site considerations
  • Medicare payment process and rates
  • Special considerations for CAHs and RHCs
• Compliance issues for telemedicine
  • Credentialing for telemedicine providers
  • Incident-to services
  • Telepresenters
• Private payer view of telemedicine services
  • More liberal usage
  • Cost savings perspective
• Congressional action relative to telehealth
  • 21^st Century Cures Act – Section
  • Proposed Connect Act
• Future of telemedicine – Rapid technological change
• Sources for further information

Who Should Attend

• Hospital/CAH case management and utilization review personnel
• Hospital/CAH coding personnel
• Billing and claims transaction personnel
• Nursing staff
• Outpatient service area personnel
• Chargemaster coordinators
• Financial analysts
• Compliance personnel
• Physicians
• Non-physician practitioners
• Other interested personnel

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