Telehealth: CMS Moves Virtual Health Forward

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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 summarizes CMS proposals in the 2019 Medicare Physician Fee Schedule that expand telehealth-related services and update payment policy for virtual care. It is aimed at physicians, coders, compliance staff, and health system leaders tracking Medicare reimbursement, HCPCS and CPT code proposals, and audit risk related to telehealth billing. The discussion also places the proposals in the context of CMS administrative simplification efforts and OIG scrutiny of telehealth claims.

Why This Topic Matters

Telehealth policy changes affect whether new virtual services may be paid, how existing services are valued, and what documentation or compliance issues providers should watch. The article helps readers understand the scope of CMS activity and the coding categories implicated by these proposals.

Article Sections

  1. Background

    Introduces the CMS proposed Medicare Physician Fee Schedule changes for 2019 and frames them within broader documentation, payment, and health IT policy updates.

  2. Virtual Options Are on the Horizon for Check-In and Evaluation

    Covers proposed telehealth-related HCPCS services for virtual communication, check-ins, and review of patient-submitted media.

  3. Telehealth Upkeep and Education Get a Boost

    Summarizes proposed CPT services related to remote physiologic monitoring and the general payment categories discussed for those services.

  4. Bundled Payments May Go Away

    Discusses CMS consideration of separate payment for interprofessional consultation services and the CPT code families involved.

  5. Keep Compliance in Check with Telehealth Billing

    Highlights compliance and audit concerns raised by an HHS OIG review of telehealth claims and the broader scrutiny of telehealth billing.

What You Will Learn

  • How CMS proposed to expand telehealth-related services in the 2019 Medicare Physician Fee Schedule
  • Which broad telehealth service categories were addressed in the proposed rule
  • How remote monitoring and interprofessional consultation policy changes were being discussed
  • What compliance issues were raised in relation to Medicare telehealth billing
  • How the article connects telehealth policy with health IT and payment reform

Who Should Read This

  • Physicians
  • Medical coders
  • Compliance professionals
  • Billing staff
  • Health system administrators
  • Revenue cycle teams

Codes Discussed

  • HCPCS Level II: GVCI1
  • HCPCS Level II: GRAS1
  • CPT: 990X0
  • CPT: 990X1
  • CPT: 994X9
  • CPT: 99446
  • CPT: 99447
  • CPT: 99448
  • CPT: 99449
  • CPT: 994X0
  • CPT: 994X6

Code Ranges Discussed

  • CPT: 99446-99449

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