A True Turning Point For Telehealth Reimbursement

One of the great turning points in American medicine came on July 30, 1965 when Lyndon Johnson signed the law introducing Medicare. Feb. 9 of this year was likewise a red-letter day. That’s when Congress passed legislation with major changes to telehealth coverage as part of the federal budget deal. Here are some of the highlights:

  • Eliminating geographic restrictions on telestroke consultation services and expanding Medicare reimbursement.
  • Widening telehealth options for Medicare Advantage (MA) plans and accountable care organizations (ACOs).
  • Adding a patient’s freestanding home dialysis site, without geographic restrictions, to the list of originating sites for monthly telehealth assessments with a nephrologist.Let’s take a closer look at the next steps and implications for the patients, providers, and organizations who will benefit most:

Telestroke – By expanding access to life-saving telehealth technology to 40 million previously underserved Medicare beneficiaries, the legislation creates many more opportunities for spoke hospitals and provides incentives for recruiting more stroke neurologists at hub hospitals.

MA plans – Now there’s a strong financial and value-based incentive for MA plans to more robustly utilize telehealth services. The new legislation paves the way for MA plans to add telehealth benefits to their core offerings for the Medicare population.

ACOs – The new legislation moves the market toward two-sided ACOs that offer greater savings – and offers ACOs more incentives for using telehealth across the care continuum.

Home dialysis for end-stage renal disease – Offers far greater convenience for thousands of kidney patients and dramatically increases billing/reimbursement opportunities for telenephrology consultations.

The words “game-changer” and “paradigm shift” don’t fully convey the magnitude of what was accomplished in Washington on Feb. 9. It’s the biggest policy victory in in the history of telehealth – and a victory for patients and providers everywhere.

For a deeper dive into recent and pending federal telehealth legislation, watch this webinar presented by Jordana Bernard, MBA, Director of Policy and Public Affairs at InTouch Health.



Select Language »