TherapySites Blog How to Be Reimbursed for Telemedicine

If you’re interested in implementing telemedicine into your practice or have already done so but have questions about how to be reimbursed for the care you provide, this article will give you a basic overview of your options. We’ll also show you how to research for your specific practice, so you can know which questions you need to consider and ask. Determining Factors for Reimbursement The Originating Site This is the location of the client while the services are being remotely delivered. Some of the most common originating sites are the client’s home, federally qualified health center, hospital, physician’s office, or a long-term care facility. The Distant Site This is the location of the healthcare provider at the time of the remote telehealth session. Common distant site locations include a hub site, specialty site, provider or physician site, and a referral site. Your Licensure The licenses you hold can determine if your services are eligible when they’re delivered remotely. Generally, you must be licensed in the state your client resides, although there are some interstate licensure agreements in development. Eligible CMS/CPT Codes The Centers for Medicare and Medicaid Services (CMS) will decide whether to approve a CPT code for reimbursement based on the category of the service provided. CPT codes are based on two categories: Category 1 Services Services that are similar to existing services, such as psych consults and office visits, that are already approved for telehealth delivery. Category 2 Services Services that are not similar to existing Medicare-approved telehealth services. Payer Policy Because there are no standardized parameters for reimbursement policy across all states and payers, it’s important for you to research factors such as each of your contracted insurance providers, state-specific guidelines in the states you are licensed to practice, and any relevant federal guidelines. Federal Reimbursement: Navigating Medicare Medicare allows reimbursement based on what type of healthcare provider you are. This includes clinical psychologists, clinical social workers, and registered dieticians. Medicare will pay an originating site facility fee for covered telehealth services. As we said earlier, care must be provided at the proper type of originating […]