Telemedicine Reimbursement

Reimbursement for telemedicine and telehealth services by medicare, medicaid and private insurance is pivotal to the adoption and growth of telemedicine. Correct billing and coding are vitally important to appropriate payment. The iTelemedicine Guide to Telemedicine and Telehealth Reimbursement and Coverage provides up-to-the-minute information on regulatory and legislative developments, as well as resources for navigating regional reimbursement issues, billing and coding.

Telemedicine seeks to improve a patient’s health by employing real time interactive communication between the patient, and the physician or practitioner at the remote site. This remote communication incorporates the use of communications solutions that includes audio and video equipment, software or cloud services and connected devices. Telemedicine is viewed by as a cost-effective alternative to traditional face-to-face medical care, and a means for delivering care to underserved regions and categories of patients.

Reimbursement for covered telemedicine services must satisfy federal requirements of efficiency, economy and quality of care. State requirements vary as “States are encouraged to use the flexibility inherent in federal law to create innovative payment methodologies for services that incorporate telemedicine technology. For example, states may reimburse the physician or other licensed practitioner at the distant site and reimburse a facility fee to the originating site. States can also reimburse any additional costs such as technical support, transmission charges, and equipment. These add-on costs can be incorporated into the fee-for-service rates or separately reimbursed as an administrative cost by the state. If they are separately billed and reimbursed, the costs must be linked to a covered Medicaid service.” Medicaid indicates.


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