Program_Memos / 2001 / AB-01-69

Why This Topic Matters

The memorandum documents a major update to Medicare telehealth payment policy and the related billing framework. It helps readers determine whether a telehealth service, site, or practitioner falls within the policy discussed in the article.

Article Sections

1. Summary

   Overview of the telehealth payment expansion, timing, and broad policy changes addressed by the memorandum.

2. Eligibility Criteria

   General beneficiary and originating-site eligibility framework, including the types of locations addressed by the policy.

3. Coverage of Telehealth

   The categories of services included in the expanded telehealth benefit and the general scope of coverage discussed in the memo.

4. Conditions of Payment

   Payment conditions tied to telecommunications technology, participation requirements, and special circumstances for certain demonstration programs.

5. Payment Methodology for Physician/Practitioner at the Distant Site

   How payment for the distant-site professional service is described, including practitioner eligibility and high-level billing considerations.

6. Originating Site Facility Fee Payment Methodology

   Facility-fee payment framework for originating sites across different facility types and settings.

7. Submission of Telehealth Claims

   General claim submission instructions for distant-site professional services and originating-site facility fees.

8. Carrier and Intermediary Instructions

   Administrative directions for carriers and intermediaries regarding publication of the telehealth changes.

9. Professional Service - Carriers

   Carrier claim handling for professional telehealth services and the associated telehealth modifiers referenced in the memorandum.

10. Originating Site Facility Fee - Carriers and Intermediaries

    Billing and processing instructions for the originating-site fee across carriers and intermediaries.

11. Carrier Editing of Telehealth Claims

    Claim-editing guidance for telehealth submissions, including processing and denial handling topics.

12. Professional Service

    Editing considerations for professional telehealth claims and provider-authorization checks.

13. Enrollment

    Statement regarding enrollment impact, or lack of impact, for telehealth participation.