CMS Announces Additions to Telehealth coverage for 2011

We are very pleased that the Centers for Medicare and Medicaid Services (CMS) have finalized all of their proposed telehealth code additions that were originally published in June 2010. These changes will go into effect January 1, 2011.
CMS finalized their proposals to add the following requested services to the list of Medicare telehealth services for CY 2011:
Individual and group kidney disease education (KDE) services (HCPCS codes G0420 and G0421, respectively);

Individual and group diabetes self-management training (DSMT) services, with a minimum of 1 hour of in-person instruction to be furnished in the year following the initial DSMT service to ensure effective injection training (HCPCS codes G0108 and G0109, respectively);

Group medical nutrition therapy therapy (MNT) and health and behavior assessment and intervention (HBAI) services (CPT codes 97804, and 96153 and 96154, respectively);

Subsequent hospital care services, with the limitation for the patient's admitting practitioner of one telehealth visit every 3 days (CPT codes 99231, 99232, and 99233); and

Subsequent nursing facility care services, with the limitation for the patient's admitting practitioner of one telehealth visit every 30 days (CPT codes 99307, 99308, 99309, and 99310). Furthermore CMS is revising §410.78(b) and §414.65(a)(1) accordingly. Specifically, the agency is adding individual and group KDE services, individual and group DSMT services, group MNT services, group HBAI services, and subsequent hospital care and nursing facility care services to the list of telehealth services for which payment will be made at the applicable PFS payment amount for the service of the practitioner. In addition, CMS reordered thelisting of services in these two sections and removed "initial and follow-up inpatient telehealth consultations furnished to beneficiaries in hosptals and SNFs "in §410.78(b) because these are described by the more general term "professional consultations" that is in the same section. Finally, CMS is continuing to specify that the physician visits required under §483.40(c) may not be furnished as telehealth services.

The telehealth originating site facility fee was raised to $24.10.

The full final rulemaking is available at  http://www.ofr.gov/OFRUpload/OFRData/2010-

27969_PI.pdf  with the major telehealth section from pages 486 to 526. There are other provisions addressing more specific forms of telehealth, such as cardiac event monitoring. This final rule is scheduled to be printed in Federal Register on November 29, 2010.

Source: American Telemedicine Association