February 19, 2014

Question:

Jennifer,

I'm interested in billing patients for visits over skype.  Can I do this?

Thanks,
Dr. R

Answer:

Yes, but be careful.  Medicare Learning Network has a CMS policy directly on point stating rural providers may bill for certain telehealth services.  Practitioners working in non-rural areas are not authorized to provide telehealth services for reimbursement from the Federal health program. Similarly, a practitioner is not authorized to bill federally funded plan beneficiaries out of pocket for covered services.  So while the option remains to provide services to patients that are not covered and charge out of pocket expenses, for Medicare beneficiaries you are not authorized to maintain telehealth visits, charge out of pocket, when the same visit would be covered by Medicare if the patient were seen in your office.  

If you do qualify to charge for telehealth visits, be sure to qualify for the required service requirements - that your system is interactive audio and video telecommunications in real-time. 

Click here to see if your location qualifies - http://datawarehouse.hrsa.gov/telehealthAdvisor/telehealthEligibility.aspx

Also, be careful how you store and maintain any data from such visits, as same is protected health information and must be treated by adherence to your security policy, with required administrative, technical and physical safeguards.

To view Medicare's policy, click here - http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/telehealthsrvcsfctsht.pdf.

State Medicaid programs have their own rules regarding Telemedicine.  To view NY's rules, click here - http://www.health.ny.gov/health_care/medicaid/program/update/2011/2011-09.htm.