Medicare

 

Medicare Reimbursement
Patient location
To qualify for reimbursement a patient must be in one of the following:
-A county outside of a metropolitan statistical area (MSA) or
-A rural health professional shortage area (HPSA).
The patient may be in:
-Physician office
-Hospital (in patient or out patient)
-Critical access hospital (CAH)
-Rural health clinic (RHC)
-Federally qualified health center (FQHC)
-Skilled nursing facility
-Community mental health center (CMHC)
-Dialysis center (hospital based)
Provider locationNo limit
Provider types-Physician
-PA
-Nurse practitioner
-Nurse midwife
-Clinical nurse specialist
-Clinical psychologist
-Clinical social worker
-Registered dietitian

Reimbursement amount-The provider site payment is the same as face-to-face services
-The patient site can bill for a telemedicine facility fee.
Telemedicine services coveredCovers all interactive teleconferencing when patient is on the conference. Does not cover home monitoring or store-and-forward.
InsuranceNo additional malpractice insurance is necessary.
LicensingMust be licensed in state where patient is located, but no special license is needed.
CredentialingNo additional credentialing is necessary.

Medicare Telehealth Eligibility

Find out if your telehealth site is eligible for Medicare reimbursement

Click Here

For specific services covered please see CMS CPT codes.