Telehealth definitions and reimbursements vary widely

For all the praise telehealth has received in providing efficient and effective access to patients who find travel difficult, are institutionalized or live in medically underserved areas, it is unclear if primary care providers are using the technology.

This was the finding of a study conducted by Fernando Wilson, Ph.D., associate professor, health services research & administration, and acting director of the College of Public Health Center for Health Policy. The study was released this week by the Health Care Cost Institute (HCCI).

Telehealth encompasses a broad variety of technologies and tactics — from telephone to remote patient monitoring — to deliver virtual medical, health and education services.

A large body of research has demonstrated the potential of telehealth technologies in increasing access to care with the same or improved patient outcomes compared to traditional in-person services.

But, it’s still relatively new. Within the past five years, there have been more than 65 state laws implemented nationwide related to delivery of telehealth-related services. Most states have implemented policies for private physicians and Medicaid programs to either facilitate reimbursement or establish guidelines for telehealth-related services and reimbursements, but none are consistent.

“These policies are all over the map,” Dr. Wilson said.

While many states permit reimbursements for telehealth services, only seven states have laws that explicitly require primary care physicians who practice telemedicine to be reimbursed at the same rate as an office visit. Analyzing private claims for more than 50 million individuals, he found that reimbursement for telehealth services is nearly 40 percent lower than for in-person visits.

“More research needs to be done. We can’t determine if providers are using telehealth, but not coding for it,” Dr. Wilson said.

Co-authors on the study are: Kate Trout and Sankeerth Rampa, graduate assistants, services research & administration, and Jim Stimpson, Ph.D., associate dean for Academic Affairs, School of Public Health, City University of New York, New York.

Nebraska's telehealth law

Telehealth means the use of medical information electronically exchanged from one site to another, whether synchronously or asynchronously, to aid a health care practitioner in the diagnosis or treatment of a patient. Telehealth includes services originating from a patient's home or any other location where such patient is located, asynchronous services involving the acquisition and storage of medical information at one site that is then forwarded to or retrieved by a health care practitioner at another site for medical evaluation, and telemonitoring. (LB 1076) & LB 257 (2015).

Telehealth consultation means any contact between a patient and a health care practitioner relating to the health care diagnosis or treatment of such patient through telehealth.

Telehealth is a Medicaid-covered service delivered by a health care practitioner that utilize an interactive audio and video telecommunications system that permits real-time communication between the health care practitioner at the distant site and the client at the originating site.
Telehealth services do not include a telephone conversation, electronic mail message, facsimile transmission between a health care practitioner and a client, a consultation between two health care practitioners and asynchronous "store and forward" technology.

No reimbursement for email, telephone, FAX or

Telehealth definitions and reimbursements vary widely

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Nebraska's telehealth law

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