Medicare Rules and Regulations for Telemedicine or Telehealth Services
Telemedicine services continue to grow both in volume and breadth of coverage. Much of the guidance for telemedicine or telehealth services comes from the Medicare program and changes occur almost every year. 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.
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 21st Century Cures Act direct 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.
This session by expert speaker Duane C. Abbey, Ph.D., will help you understand the general concept of telemedicine and how it works. Duane will review the current Medicare rules and regulations surrounding these services and explain how telemedicine services are paid under the Medicare program.
- How is telemedicine supposed to work?
- Underlying technology and advancements
- Current Medicare rules and regulations surrounding telemedicine services
- Why is the terminology so confusing?
- What is the difference between telemedicine and telehealth?
- Who is involved in telemedicine?
- Who is allowed to provide telemedicine services?
- How to code and bill for telemedicine services?
- The reimbursement process for telemedicine services under the Medicare program
- How are telemedicine services paid under the Medicare program?
- What do hospitals, CAHs and clinics need to do in order to bill for telemedicine services?
- Is there anything special about RHCs (Rural Health Clinics)?
- Are there any compliance issues for telemedicine?
- How do private third-party payers view telemedicine and telehealth services?
- How will the 21st Century Cures Act impact telemedicine and telehealth?
- Special requirements for physicians and practitioners
- Clinical and billing privileges surrounding telemedicine
- Changes in credentialing for physicians providing telehealth services
- Changes in coverage and types of services that can be provided through telemedicine
- Unusual requirements for different providers relative to telemedicine services
- Identify future changes for telemedicine particularly with Medicare
- Telemedicine Services
- Telehealth Services
- General Process
- Review of Terminology
- Current Legislation – 21st Century Cures Act
- Underlying Technologies
- Interactive Communications
- Electronic Monitoring
- Remote Robotic Services
- Clinical Issues for Telemedicine
- Non-Physician Practitioners
- Consultation Services
- Updating Telemedicine
- What services can be provided?
- Who can provide services?
- Where can services be provided?
- Coding, Billing and Reimbursement Issues
- Coding and Claims Filing Requirements
- Special Codes and Modifiers
- Distant Site Consideration
- Originating Site Considerations
- Special Considerations for CAHs
- Special Considerations for RHCs
- Compliance Issues for Telemedicine
- Credentialing for Telemedicine Providers
- Incident-To Services
- Private Payer View of Telemedicine Services
- More Liberal Usage
- Cost Savings Perspective
- Congressional Action Relative to Telehealth
- 21st 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
- Charge master Coordinators
- Financial Analysts
- Compliance Personnel
- Non-Physician Practitioners and Other Interested Personnel
At the Q&A session following the live event, ask a question and get advice unique to your situation, directly from our expert speaker.
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