Telehealth Update – CMS to Start Covering in Home Monitoring
Telehealth update: Health plans are beginning to offer telemedicine services to their insureds that offer 24/7 access to online doctor visits. For example, BlueCare is a benefit for most insureds of BlueShield of Louisiana. As a result, online visits are intended to serve members with non-emergency minor illnesses such as colds (ICD-10 code R09.81 – Nasal congestion). Also, allergies, bladder infections (for example O86.22 – Infection of bladder following delivery), sinus trouble, mild stomach upsets or rashes. Due to these developments, patients can have an encounter with a physician via mobile device such as an iPhone, iPad, or Android device, over their desktop computer or laptop.
According to the Center for Connected Health Policy, “Telehealth is a collection of means or methods for enhancing health care, public health, and health education delivery and support using telecommunications technologies. Telehealth encompasses a broad variety of technologies and tactics to deliver virtual medical, health, and education services.”
Although BlueCare offers a limited set of services initially, Telemedicine services that are eligible for coverage under Medicare including the following HCPCS and CPT codes:
- Telehealth consultations, emergency department or initial inpatient (G0425-G0427). Effective Jan. 1, 2010.
- Follow-up inpatient telehealth consultations (G0425-G0427). Effective Jan. 1, 2009.
- Office or other outpatient visits (99201-99215).
- Subsequent hospital care services, with the limitation of one telehealth visit every three days (CPT codes 99231-99233). Effective Jan. 1, 2011.
- Subsequent nursing facility care services, with the limitation of one telehealth visit every 30 days (99307-99310). Effective Jan. 1, 2011.
- Pharmacologic management March 1, 2003 – Dec. 31, 2012 (90862). (G0459) Effective Jan. 1, 2013
- Individual psychotherapy (90804-90809); Psychiatric diagnostic interview examination (90801). Effective March 1, 2003 – Dec. 1, 2013.
- Individual psychotherapy (90832-90834, 90836-90838) ; Psychiatric diagnostic interview examination (90791-90792) Effective Jan. 1, 2013.
- Neurobehavioral status exam (96116). Effective Jan. 1, 2008.
- End Stage Renal Disease (ESRD) related services (90951, 90952, 90954, 90955, 90957, 90958, 90960, and 90961). Effective Jan. 1, 2009.
- Individual and group medical nutrition therapy (G0270, 97802-97804). Individual effective Jan. 1, 2006. Group effective Jan. 1, 2011.
- Individual and group health and behavior assessment and intervention (96150-96154). Individual effective Jan. 1, 2010; group effective Jan. 1, 2011.
- Individual and group kidney disease education (KDE) services (HCPCS codes G0420-G0421). Effective Jan. 1, 2011.
- Individual and group diabetes self-management training (DSMT) services, with a minimum of 1 hour of in-person instruction to be furnished in the initial year training period to ensure effective injection training (G0108-G0109). Effective Jan. 1, 2011.
- Smoking Cessation Services (99406-99407 and G0436-G0437). Effective Jan. 1, 2012.
- Alcohol and/or substance (other than tobacco) abuse structured assessment and intervention services (G0396-G0397) Effective January 1, 2013.
- Annual alcohol misuse screening (G0442) Effective January 1, 2013.
- Brief face-to-face behavioral counseling for alcohol misuse (G0443) Effective January 1, 2013.
- Annual Depression Screening (G0444) Effective January 1, 2013.
- High-intensity behavioral counseling to prevent sexually transmitted infections (G0445) Effective January 1, 2013.
- Annual, face-to-face Intensive behavioral therapy for cardiovascular disease (G0446) Effective January 1, 2013.
- Face-to-face behavioral counseling for obesity (G0447) Effective January 1, 2013.
- Transitional Care Management Services (99495-99496) Effective January 1, 2014.