Expansion of teleconsults eyed; Medicare claims still “minuscule”

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Note:  The following article synopsis was NOT provided by HCPro. It was created by Find-A-Code/innoviHealth.

Article Overview

This article examines the early Medicare teleconsultation program and reporting on how often claims were paid, where the service was being used, and why some providers and administrators were discussing expansion. It is relevant to clinicians, coders, telemedicine programs, and reimbursement staff who need to understand the broad coverage environment, participating sites, and the types of telemedicine services being discussed.

Why This Topic Matters

The piece provides context on early Medicare telemedicine reimbursement and the operational barriers affecting claim payment and program growth. It may help readers assess whether their organizations or services fall within the scope of the teleconsultation coverage discussed in the article.

Article Sections

  1. Teleconsultation program activity and expansion plans

    Covers Medicare teleconsultation utilization, participating sites, and discussion of potential program growth. Also notes broader telemedicine activity and the organizations cited in the reporting.

  2. Coverage, reimbursement, and claims processing concerns

    Discusses the reimbursement environment for teleconsultation services, including carrier payment issues and administrative concerns reported by program participants.

  3. Stored-and-forward telemedicine and specialty use

    Addresses broader telemedicine applications involving remote review of images and other data, along with the specialties mentioned as using these services.

What You Will Learn

  • How the article characterizes early Medicare teleconsultation utilization
  • What broad operational issues were reported around telemedicine claims processing
  • What categories of telemedicine services and specialties were mentioned
  • Which organizations and demonstration projects were referenced in the discussion

Who Should Read This

  • Medical coders
  • Billing and reimbursement staff
  • Telemedicine program administrators
  • Physicians
  • Compliance teams

Codes Discussed

Code Ranges Discussed

  • CPT: 99241–99245
  • CPT: 99251–99255
  • CPT: 99261–99263
  • CPT: 99271–99275

Modifiers Discussed


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