Getting Started with Telemedicine

Setting up a telemedicine-based service in your practice or organization might seem overwhelming, but we’re here to help.

We strive to make the telemedicine start-up process as simple as possible for our provider partners, and we are available for assistance every step of the way. The flowchart below is a great resource to better understand how other providers get started with telemedicine. Start in the upper left-hand corner – where you “define a needed service” – and simply follow the arrows. For more information, you can also take a look at our Telemedicine Implementation Guide or AMD Global Telemedicine’s “12-Step Webinar.”

Clinical Applications

While not all of the telemedicine-based services listed below are being used in the North Country, they are feasible to setup. Clinical applications for telemedicine range from dermatology to psychiatry, and innovations are constantly being made to expand the reach and scope of telemedicine.

To help keep our region’s providers informed about the possibilities of telemedicine, the North Country Telehealth Partnership has prepared a series of documents that list necessary clinical conditions for the following telemedicine applications:

Reimbursement Information

For providers, details of reimbursement are critical to the telemedicine implementation process and to the sustainability of existing programs. Fortunately, we are here to help guide our practices through any questions or concerns they may have. Billing and coding shouldn’t hold you back from taking advantage of telemedicine, nor should it prevent your patients from the benefits telemedicine can offer.

Current Reimbursement Landscape:

All 50 state Medicaid programs cover telemedicine in some capacity, whether live videoconferencing, store and forward, Remote Patient Monitoring, or some combination of the three. Medicare covers telehealth but with some geographic and provider restrictions.

Private payers vary greatly depending on the state. Currently, 39 states and the District of Columbia require that private insurers cover telehealth the same as they cover in-person services. This is called coverage parity and was adopted in New York State in 2016.

As you consider adding a telemedicine service to your practice or organization, we encourage you to contact the provider relations departments of any insurers you have specific questions about. A helpful resource is the Center for Connected Health Policy’s 50 State Report, which is updated semi-annually with information about insurance coverage for telemedicine.

New Reimbursement Information – Helpful Links to Most Up-to-Date Documents

NYS DOH/ Medicaid:

• Comprehensive Guidance Regarding the Use of Telehealth including Telephonic Services During COVID-19 (STATUS: Active, extended for remainder of federally declared PHE or until issuance of subsequent guidance)
• Emergency Rule Continuing Medicaid Telehealth Expansions (STATUS: Agency intends to make permanent but this emergency rule expired March 21, 2022.)
• FAQs on Telehealth and Telephonic Services (STATUS: Active, NY state of emergency ended but based on Comprehensive Guidance telehealth & telephonic policies extended for remainder of federally declared PHE or until issuance of subsequent guidance.)

Office of Mental Health (OMH):

• Emergency Rule/Proposed Rule Making Continuing Telehealth Expansions (STATUS: Agency intends to make permanent but this emergency rule expired February 12, 2022. Awaiting published guidance.)

Office of Alcoholism and Substance Abuse Services (OASAS):

• Final Rule Continuing Telehealth Flexibilities (STATUS: Active)

Medicaid 1915(c) Waiver:

• Appendix K – OPWDD/Home and Community Based Services Waiver (STATUS: Active expires six months after the end of the federal PHE.)
  

Medicare

• 2022 Physician Fee Schedule: https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/PhysicianFeeSched
• The Consolidated Appropriations Act, 2022 was passed by the U.S. House and Senate on March 9 & 10, 2022 and signed into law by President Biden on March 15, 2022. The Act extends certain telehealth flexibilities for Medicare patients for 151 days after the official end of the federal public health emergency (PHE). Currently, the PHE will end July 15, 2022 unless further extended. Here is a summary of telehealth flexibilities included in the Act:  https://www.natlawreview.com/article/congress-grants-five-month-extension-telehealth-flexibilities

Helpful Telehealth Trainings

Northeast Telehealth Resource Center (NETRC) Free Telehealth Training Portals

https://www.telehealthclassroom.org/

https://nytelehealth.netrc.org/