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Telemedicine Pays: Billing and Coding Update
Sakina S Bajowala1, Jacob Milosch2, Chandani Bansal3
1Kaneland Allergy and Asthma Center, 1213 Oak St., North Aurora, IL, 60542, USA. sakina.bajowala@kanelandallergy.com.
Telemedicine adoption was hindered by coverage uncertainty. The COVID-19 pandemic accelerated telehealth expansion, improving access and prompting policy changes for better reimbursement.
Area of Science:
- Healthcare Policy
- Medical Economics
- Digital Health
Background:
- Telemedicine offers improved access and convenience but faced adoption barriers due to unclear insurance and reimbursement policies.
- Physicians, particularly those in private practice, were hesitant to adopt telemedicine owing to these uncertainties.
Purpose of the Study:
- To review updated telemedicine coverage and payment policies in the USA.
- To provide a guide for billing and optimizing reimbursement for telemedicine services.
- To explore the future landscape of telehealth reimbursement post-public health emergency.
Main Methods:
- Comprehensive review of current telemedicine coverage and payment policies.
- Analysis of historical and recent policy changes, with a focus on COVID-19 impacts.
- Tabular guide for telemedicine billing and reimbursement optimization.
Main Results:
- The COVID-19 public health emergency led to rapid expansion of telehealth coverage and payment policies.
- Recent policy changes aim to ensure public access to healthcare via telehealth.
- The review includes practical guidance on billing and optimizing reimbursement.
Conclusions:
- Telehealth has proven its value as a safe and effective healthcare model.
- Policy changes driven by the pandemic have significantly altered the telemedicine landscape.
- Understanding and adapting to these evolving policies is crucial for healthcare providers.
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