Effective January 1, the Centers for Medicare and Medicaid Services (CMS) is expanding the definition of “originating sites” to include health professional shortage areas that are located in rural census tracts of Metropolitan Statistical Areas. Also, as part of the update to the Physician Fee Schedule for 2014, Medicare has added “Transitional Care Management Services” to the list of codes eligible for payment when provided via telehealth.
The changes are detailed in a Medicare Learning Network transmittal that includes a link for a Medicare Telehealth Payment Eligibility tool, which can assist providers in determining whether they qualify as an originating site for purposes of Medicare payment. This tool is also available on HANYS' Telemedicine Web page. Medicare defines “originating site” as the location of an eligible Medicare beneficiary at the time the service is provided via telemedicine.
Transitional care management services are provided for patients whose medical and/or psycho-social problems require moderate or high complexity medical decision-making during transitions in care from an inpatient hospital setting (including acute hospital, rehabilitation hospital, long-term acute care hospital), partial hospitalization, observation status in a hospital, or skilled nursing facility/nursing facility, to the patient's community setting. The change will allow the required face-to-face visit to be furnished through telehealth. Contact: Karen Roach