ATA Secures Another Win for Medicare Coverage of Telehealth

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CMS has published a new code (G0459) which guarantees coverage for psychiatrists and prescribing psychologists who provide rounds for patients with mental disorders in rural hospitals, The American Telemedicine Association and the American Psychiatric Association worked together to petition CMS for this new code.

American Telemedicine Association

American Telemedicine Association

ATA continues to work with CMS to expand telehealth coverage for all Medicare beneficiaries.

The Center for Medicare and Medicaid Services (CMS) has granted the American Telemedicine Association’s request to establish a new billing code covering remotely-delivered inpatient pharmacologic management services. The new code (G0459) augments Medicare funding for psychiatrists and prescribing psychologists who provide rounds for patients with mental disorders in rural hospitals. ATA joined with the American Psychiatric Association in petitioning CMS for this this change.

Effective January 1, 2013, the code is a technical correction to the agency’s earlier rule on telehealth policy which, in-effect, limited reimbursement to once every three days, and only by a psychiatrist. Code G0459 removes the frequency limit and clarifies that prescribing psychologists may also bill. The full code is available in the CMS Claims Processing Manual Transmittal.

“We are pleased that CMS has seen the wisdom of providing coverage for this needed telemedicine service, without which many rural patients would not receive the mental healthcare they need,” said Jonathan Linkous, CEO of the American Telemedicine Association. “Of course, the same need exists in urban and suburban areas and ATA continues to work with CMS to expand telehealth coverage for all Medicare beneficiaries. The current code only covers rural patients, explicitly barring 79% of Americans from receiving the same benefit. The fight for equitable, quality healthcare continues.”

The American Telemedicine Association is the leading international resource and advocate promoting the use of advanced remote medical technologies. ATA and its diverse membership work to fully integrate telemedicine into healthcare systems to improve quality, equity and affordability of healthcare throughout the world. Established in 1993, ATA is headquartered in Washington, DC. For more information visit http://www.americantelemed.org.

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Ben Forstag
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