Limits on nursing home telemedicine will stand, CMS announces

Share this article:
Medicare will continue to reimburse only one telehealth visit per month for skilled nursing facility residents, according to a recent proposed rule from the Centers for Medicare & Medicaid Services. The proposed physician fee schedule for 2014 seeks to expand telehealth in other healthcare settings. 

Under the 2011 PFS final rule, Medicare beneficiaries can be covered for one telehealth visit per 30-day period for subsequent skilled nursing facility services. The American Telemedicine Association asked CMS to remove this limitation, citing new studies and plans to create a national broadband network dedicated to healthcare.

The broadband project aims to improve rural providers' access to urban specialists, and there are already no limitations on how often urban specialists can use G-codes related to medically reasonable and necessary SNF consultations, CMS noted. 

The studies cited by the association do not provide persuasive evidence that more frequent telehealth visits would benefit SNF residents, according to CMS.

Telehealth is appropriate for SNF inpatients if it enables “appropriately frequent, medically reasonable and necessary encounters with their admitting practitioner,” the proposed rule states. However, if the current limits are removed, telehealth may be used too frequently, compromising care for “this potentially acute and complex” population.

While maintaining these limits on SNF telemedicine, the proposed rule would create new codes for physicians to provide more non-face-to-face management for certain beneficiaries with complex, chronic care needs. 

The proposed physician fee schedule will be published July 19 in the Federal Register. Click here to access a CMS fact sheet on the proposal.

Share this article:

More in News

CMS expands therapy payment research

The government is expanding its research into alternative therapy payments, to consider more holistic changes to the way Medicare reimburses skilled nursing facilities, the Centers for Medicare & Medicaid Services announced Tuesday.

CDC tightens Ebola guidelines for healthcare workers

The Centers for Disease Control and Prevention has issued more stringent guidelines for how healthcare workers should interact with Ebola patients, following an outcry from nurses and other professionals.

Nonprofit providers face alarming market forces, must rally, LeadingAge chairman says

Nonprofit providers face alarming market forces, must rally, ...

Nonprofit long-term care providers must work together to address alarming trends, or their market share could plummet and the sector as a whole could falter, LeadingAge Chairman David Gehm told ...