Payment for Telehealth Care
Should pediatricians be paid for health services provided via the telephone? Yes, and for other non-face-to-face methods such as email and telemedicine as well. Payment for telehealth care
is a topic of primary importance to AAP members.
The AAP Department of Practice recently conducted a survey on state Medicaid payment policies. The survey asked about payment policies and rates for several specific CPT codes, including telephone and online evaluation and management codes. The results will be available by Fall 2011.
Here's what the Section on Telehealth Care has done to help pediatricians get paid appropriately for these services.
1. Set policy
In 2006, the AAP published, "Payment
for Telephone Care". This policy reviewed the role of telephone care in
pediatric practice, the current reimbursement environment, and examined
the evidence supporting the notion that telephone care improves the quality
and cost of pediatric service delivery. Ethical considerations and barriers
surrounding telephone fees were discussed. The policy also gave
recommendations on how to introduce charging for telephone care to patients
and third party payers.
2. Fixed CPT codes
for Telehealth Care
The SOTC has worked with many other stakeholder groups
to create new codes
Care that include codes for telephone encounters and online visits.
Click here to access the RVUs for these codes on the Academy's RBRVS brochure.
3. Showed pediatricians how to do it. (Member Center login required)
To help pediatricians understand and implement the policy on payment
for telephone care the SOTC has revised its step-by-step tool kit. It
includes sample patient communication, phone call
documentation, billing procedures and suggestions for communicating with
third party payers. Click here for Toolkit.
None of this happened by chance or wishful thinking. It took the organization of the Section to study the problem, research alternatives, propose solutions, and advocate, advocate, advocate. That Section is
the Section on Telehealth Care (SOTC).
Get connected to the latest information on payment
for telephone care by joining the Section on
Telehealth Care. (View SOTC Membership).