New for 2018: CMS Un-Bundles CPT Code 99091 To Help Drive Healthcare Provider Reimbursement for Telemedicine

New for 2018: CMS Un-Bundles CPT Code 99091 To Help Drive Healthcare Provider Reimbursement for Telemedicine

As a first step towards recognizing remote patient monitoring services for separate payment, the Centers for Medicare and Medicaid Services (CMS) has un-bundled CPT code 99091. This allows providers to be reimbursed separately for time spent on collection and interpretation of health data. This includes patient data that is generated remotely, digitally stored and transmitted to the provider, at a minimum of 30 minutes of time.

Some of the key guidelines on the use of this code include the time spent accessing, reviewing or interpreting the data and any necessary modifications to the care plan that result (such as communication with the patient and/or her caregiver and any associated documentation). Providers can use code 99091 once in a 30-day period per patient, and the code will not be subject to any of the restrictions on originating sites or technology that telehealth services are subject to by statute, allowing for more flexibility.

“This year, CMS is supporting clinicians who leverage remote monitoring services and tools more than ever with the un-bundling of CPT code 99091,” said SnapMD CEO, Dave Skibinski. “We are encouraged by regulatory changes that will continue to make it easier for healthcare providers to treat diverse patient populations virtually.”

In addition, CMS has included several new services this year that will be reimbursed when performed using telehealth technology. These include:

  • Counseling visits for lung cancer screening (HCPCS code G0296)
  • Psychotherapy for crisis (CPT codes 90839 and 90840)
  • Interactive complexity (CPT code 90785)
  • Patient-focused and caregiver-focused health risk assessments (CPT codes 96160 and 96161)
  • Chronic care management services including assessment and care planning (HCPCS code G0506)

 

SnapMD looks forward to continued health IT innovation and constituency support for telemedicine in the coming year.