Providers Encouraged to Push For Telemedicine Codes

Providers should use telemedicine codes whenever possible and become more proactive about lobbying for broader acceptance of telemedicine codes industry-wide, an expert urges.

The Centers for Medicare and Medicaid Services (CMS) are starting to consider telemedicine reimbursement with new “S” codes, but providers can get a jump on things by lobbying for the codes’ acceptance ahead of the 2014 ICD-10 transition, Foley Hoag attorney Caleb Des Rosiers told SearchHealthIT.com.

Des Rosiers acknowledged that there’s “chaos” and “resistance” among payers for telemedicine reimbursement, but he encouraged hospital information managers as well as executives to consider the following when shaping up their telemedicine claims:

  • Even though CMS introduced eight new telehealth codes for 2013, billing staff should expect to lobby for reimbursement for claims that have been submitted and rejected using these new codes.
  • Commercial payers and Medicaid are more likely to reimburse with use of telehealth codes since Medicare has limited billing codes.
  • If all other telemedicine codes fail, use the S9110. Even though the code isn’t recognized by Medicare, commercial payers and Medicaid can be swayed to accept it if providers push.
  • Providers must accept that the payer determines the rate, emphasizes Des Rosiers. “The rates can’t be anemic. It’s a matter of them understanding these new codes, but more importantly, digging in further and asking, ‘Is there an economic value to these codes?’” he told the publication.

 

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