medicare reimbursement for telehealth services - afhcan

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CMS Eligible Originating Sites • Physician or practitioner office • Hospital • Critical access hospital (CAH) • Rural health clinic (RHC) • Federally qualified health center (FQHC) and as of 1/1/09: • Skilled nursing facility (SNF) • Hospital-based dialysis center (HDC) • Community mental health center (CMHC) 34
CMS Location of Facility • The originating site (where the eligible Medicare beneficiary is located) must be an eligible facility located outside of a Metropolitan Statistical area • No facility limitation on the location of the health professional delivering the medical service (referring site) 35
Page 1 and 2: REIMBURSEMENT FOR TELEHEALTH SERVIC
Page 3 and 4: Two forms of transmission • Live,
Page 5 and 6: Telemedicine and HIPAA http://www.h
Page 7 and 8: Definition of Interactive Two-way,
Page 9 and 10: Store & Forward Medical Information
Page 11 and 12: Visit 1 Patient is seen by a nurse
Page 13: Telemedicine in the Alaska Tribal H
Page 16 and 17: Maniilaq Health Center Kotzebue, Al
Page 18 and 19: Yukon Kuskokwim Delta Regional Hosp
Page 20 and 21: Mt. Edgecumbe Hospital Sitka, Alask
Page 22 and 23: Community Health Aide 22
Page 24 and 25: AFHCAN • Alaska Federal Health Ca
Page 26 and 27: Version 3 •Basic Cart: •Otoscop
Page 28 and 29: Typical round trip airfares to Anch
Page 30 and 31: AFHCAN Sites in Alaska 248 AFHCAN S
Page 32 and 33: Telemedicine Sites 32
Page 36 and 37: Telemedicine Providers 36
Page 38 and 39: Requesting Provider (originating si
Page 40 and 41: Distant Site Provider Evaluates/tre
Page 42 and 43: Example of Presenting Provider Mond
Page 44 and 45: Provider Documentation • Follow s
Page 46 and 47: Telemedicine Modifiers • HCPCs Le
Page 48 and 49: Covered Behavioral/Mental Health Se
Page 50 and 51: Covered Nutrition Services - Medica
Page 52 and 53: Four R’s of Consultations 1. Requ
Page 54 and 55: Exception • In Alaska and Hawaii,
Page 56 and 57: Visit 1 Patient is seen by a nurse
Page 58 and 59: Visit 1 • Problem focused exam
Page 60 and 61: Visit 2 The dermatologist receives
Page 62 and 63: 1500 Consult 99241 GQ Modifier for
Page 64 and 65: Multiple Consultations Point Hope K
Page 66 and 67: INTERACTIVE EXAMPLE 66
Page 68 and 69: Visit 1 • Nurse Practitioner sees
Page 70 and 71: 1500 99212 for faceto-face visit No
Page 72 and 73: Visit 2 This visit meets the criter
Page 74 and 75: Visit 3 • The orthopedic surgeon
Page 76 and 77: Consult code with a GT modifier for
Page 78 and 79: REIMBURSEMENT - ORIGINATING SITE
Page 80 and 81: COMMERCIAL PAYORS 80
Page 82: Questions? Cheryl A. Skiffington, C

medicare reimbursement for telehealth services - afhcan

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