Telemedicine is here and is likely to grow with the addition of millions of recently insured patients under the Affordable Care Act, said Dubeck, an internist and chief medical officer for medical policy and clinical editing at Excellus BlueCross BlueShield, Rochester, N.Y. “The sky's the limit,” Dubeck said. “What's happening with the advancement in technology (is) the current code set is not meeting the needs of provider, vendors and payers." Another telehealth driver is the demand for healthcare services by self-funded employer groups. “They want their employees to be at work,” Dubeck said, and telehealth visits help make that happen. Private payers, meanwhile, have small-scale pilots of potentially beneficial telehealth services.
The American Medical Association is creating a suite of codes to enable the reimbursement of telemedicine, with a working group dispatched to create the list November. The codes are utilised by health providers, insurers and Medicare to make clear what services providers have performed. The creation of these codes means more payers and Medicare are likely to cover telemedicine services as it allows them to delineate exactly what services have been performed, currently a variety of "face-to-face" codes are being used to bill for telemedicine services. The working group comprises some 50 members from the physician and telemedicine communities, and will reconvene in last week.