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Telehealth

Telehealth. Presented by Marti Coté, R.N. and Tiffany Lewis. What is Telehealth?. Telehealth is the use of a telecommunications system to substitute for an in-person encounter.

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Telehealth

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  1. Telehealth Presented by Marti Coté, R.N. and Tiffany Lewis DHCFP

  2. What is Telehealth? • Telehealth is the use of a telecommunications system to substitute for an in-person encounter. • In order to be reimbursed by Nevada Medicaid, an interactive audio and video telecommunications system must be used that permits real-time communication between the provider at the distant site and the recipient at the originating site DHCFP

  3. Telehealth Sites DHCFP will reimburse for telehealth services with the following site guidelines: • Originating site must be located in either a rural Health Professional Shortage Area (HPSA), or in a county that is not included in a Metropolitan Statistical Area (MSA) • Distant site provider is located at the time the service is provided via a telecommunication system DHCFP

  4. Originating Sites The originating sites authorized by law are: • Offices of physician or practitioners; • Hospitals; • Critical Access Hospitals (CAH); • Rural Health Clinics (RHC); • Federally Qualified Health Centers (FQHC); • Hospital-based or CAH-based Renal Dialysis Centers (including satellites) • Skilled Nursing Facilities (SNF) • Community Mental Health Centers (CMHC) DHCFP

  5. Distant Site Practitioners Practitioners at the distant site who may furnish and receive reimbursement for telehealth services are: • Physicians; • Nurse practitioners (NP); • Physician assistants (PA): • Nurse midwives • Clinical psychologists (CP) • Clinical social workers (CSW) DHCFP

  6. Types of Telehealth communications • asynchronous telecommunications • single media format Telehealth communications do NOT include the following without visualization of the patient: • telephone calls • images transmitted via fax • text messages (electronic mail) DHCFP

  7. Non-Covered Forms of Communications • Skype • Face Time • AT&T connect • Logitech • IP phones DHCFP

  8. Covered Telehealth Services • Office or other outpatients visits • Subsequent hospital care; 1 every 3 days • Nursing Facility care services; 1 every 30 days • Inpatient consultations • Individual psychotherapy • Pharmacologic management • Diabetes Self-Management Training, individual and group • Smoking cessation services • ESRD-related services For more information, refer to CMS Fact Sheet at www.cms.gov/MLNProducts/downloads/TelehealthSrvcsfctsht.pdf DHCFP

  9. Limitations of Services • The exam of the patient is under control of the distant provider. • A Tele-presenter is not required as condition of payment, unless medically necessary as determined by distant site provider. • No Prior Authorization is required. DHCFP

  10. Limitations of Servicescont. • CP and CSW cannot bill for psychotherapy services that include medical evaluation and management services. • For ESRD-related services, at least one “hands-on” visit must be furnished each month to examine the vascular access site. • DSMT must include at least 1 hour “in-person” of the 10-hour benefit in the year following the initial DMST. DHCFP

  11. Questions? DHCFP

  12. Questions? DHCFP

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