Reimbursement: Proposed Rule: Enjoy Expanded Coverage for Telehealth Services

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

Article Overview

This article reviews a CMS proposed rule for the calendar year 2017 Medicare Physician Fee Schedule that would expand Medicare telehealth coverage and adjust related payment policies. It is aimed at coders, billers, compliance staff, and telehealth stakeholders who need to track which service categories are being considered, how CMS is handling telehealth payment policy, and which CPT and G-code additions were proposed. The piece also summarizes services CMS declined to add and notes related changes affecting telehealth reporting and care-management requirements.

Why This Topic Matters

Telehealth reimbursement policy changes can affect coverage, documentation, and billing workflows for multiple specialties. This article helps readers understand the scope of proposed Medicare telehealth expansion and the coding categories involved.

What You Will Learn

  • Which categories of telehealth services CMS proposed to add to Medicare coverage
  • What kinds of telehealth services CMS considered but did not propose
  • Which new billing code families were discussed in connection with telehealth
  • How the proposed rule relates to Medicare Physician Fee Schedule policy updates
  • What broader telehealth reimbursement topics were identified in the article

Who Should Read This

  • Medical coders
  • Billing staff
  • Compliance teams
  • Telehealth program managers
  • Physician practices
  • Hospital reimbursement staff

Codes Discussed

  • HCPCS Level II: GTTT1
  • HCPCS Level II: GTTT2
  • CPT: 90967
  • CPT: 90968
  • CPT: 90969
  • CPT: 90970
  • CPT: 99497
  • CPT: 99498
  • CPT: 99490

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