3) Telemedicine Billing & Reimbursement

Telemedicine is an excellent way to increase revenue and profitability for your practice. Telemedicine billing is fairly straightforward for both private payers and government payers, such as Medicare and Medicaid. This article will address both.

Private Payers

Most private payers are now reimbursing for telemedicine similarly to in-office visits. In fact, a growing number states require that they do so.

1
Simply schedule a telemedicine visit by selecting “Telemedicine” as the location for visit and Chiron will automatically verify the patient’s eligibility for telemedicine. Telemedicine-specific eligibility will be found in the notes section of the appointment object.

In terms of coding, standard E/M guidelines apply to telemedicine.
  • Existing Patients: 99213 - 99214
  • New Patients: 99202 - 99203
2
Patient payment collection is a feature that can be enabled or disabled practice-wide upon request. When it's enabled, all patients across the board are required to enter in a valid payment method before entering the session. Providers ultimately control what, if anything, is charged to that payment method at the end of the session. 

Government Payers

  • Medicare and Medicaid typically do not reimburse for telemedicine when the patient is in the home. However, telemedicine visits ARE reimbursable through Medicare & Medicaid when the patient is located at a qualified healthcare facility in a rural community.
  • More information from CMS on telemedicine reimbursement can be found here: http://go.cms.gov/20WVqC2
  • Many practices still see Medicare patients using telemedicine. Self-pay rates of $40-$50 are typically charged.
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