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Telemedicine expert talks remote consult codes, payment trends

Part B News has covered the rollout of Medicare's newly-covered codes for interprofessional consultations performed via communications technology (99446-99452). Here with a few expert opinions on the subject, and on trends in remote medicine payments, is Samant Virk, M.D., founder & CEO of MediSprout, a healthcare and telehealth solutions company in Valhalla, N.Y.
These codes represent a slight relaxation of CMS’ very rigorous requirements for all telehealth services. Do you have reason to believe CMS will loosen up even more in the next few years? Why?

The US spends a staggering $3.3 trillion annually, largely going toward chronic — often preventable — diseases, including diabetes, heart disease, and back and neck pain.
With innovative technology allowing accurate and up to date patient readings, doctors will be able to treat patients from anywhere at any time. The convenience factor of follow-ups, prescription refills, test results and more will allow patients to better communicate with their doctors between visits.
As the continuity of care via non-face-to-face services improves, the amount that Americans spend on healthcare overall is going to decline and this number will help drive more relaxed requirements. The gaps in care between in-person doctor visits is where many of these treatment plans come apart, and we end up providing reactive care rather than the proactive care telemedicine can offer. With telemedicine I know we can make a great impact in helping our patients manage their chronic care needs to avoid these debilitating healthcare costs. It’s just a matter of time before the reimbursement structure recognizes this and implements a structure to support it.

Are private insurers ahead of the curve in relation to Medicare on this?

Medicare is making strides to cover telehealth visits and it is headed in the right direction with recent coverage of chronic conditions with the CHRONIC Care Act [part of the Bipartisan Budget Act of 2018].  The thought is that they are being cautious but will continue to expand coverage over the coming years. Private insurers, in this case, have been reimbursing for these surgical visits and much more. There is a great opportunity for clinicians to improve care continuity and create flexibility with their time with these private insurers reimbursing.
Do you or anyone else at MediSprout believe that payers will become more likely to pay for these services over the next few years? Or over the next ten years? Or not at all?

I believe that people will pay a premium for convenience. They already are. Look at Amazon, Fresh Direct, Stitch Fix, and Warby Parker — these are all services that allow people to get what they need without spending time at the store. But why don’t we see this in healthcare? There are many services that can be done via teleconferencing with your doctor. Why not cut out travel time and wait time and have a virtual visit straight from your office, vacation, school, or home?
Editor's note: Learn about Medicare’s new policies for interprofessional consults and communications-based encounters. Register for our 60-minute webinar Electronic E/M Is Here: Earn Revenue for Virtual Consults, Visits, and Remote Monitoring, Tues. March 12, 1-2 p.m., ET.
Blog Tags: CMS
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