The Pandemic is Pushing Providers to Reconsider Role of Telehealth

While telemedicine is nearly two decades old, until recently, it was considered an impractical addition to more mainstream care environments. As a result, utilization remained low, even as access to high speed internet exploded. But in recent months, in the face of the COVID-19 pandemic, providers have begun to adopt the technology at a record pace. With face-to-face care disrupted and reimbursement for virtual appointments dramatically modified, telehealth now makes sense for most physicians—especially for those in the clinic and emergency setting.

INSIDE THE NUMBERS

The numbers tell the story. Telehealth utilization:   

• Has increased 51% during the Pandemic (“HHS Issues New Report Highlighting Dramatic Trends in Medicare Beneficiary Telehealth Utilization amid COVID-19”)
• Telehealth revenue is predicted to reach $20 Billion in 2020 (arziton “U.S. Telehealth Market - Industry Outlook and Forecast 2020-2025”)

REIMBURSEMENT RESTRICTIONS REMOVED

In regards to reimbursement for telehealth, we are in a whole new world. CMS has implemented waivers that remove many of the restrictions that have hampered expansion. Specifically, CMS will reimburse for telehealth visits on par with in-person provider visits, and Emergency Physicians may submit ED E&M Codes 99281-99285 with a Modifier -95 OR Office E&M Codes 99202-99205 or 99212-99215 with a Modifier -02 for reimbursement by CMS. Most Commercial payers are also reimbursing for the same services with many preferring the ED E&M Codes and a Modifier -02.

Telemedicine is here to stay, and most of the CMS Value Based Reimbursement Models include it as part of the care process.  

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