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Clinicians can provide (“remotely telepresent”) telemedicine services to medicare beneficiaries so long as those beneficiaries are at a “qualified originating site.” What is an originating site you ask? An originating site must be one of the following: a physician’s or practitioner’s office; a hospital; a critical access hospital; a rural health clinic; a federally qualified health center; a skilled nursing facility; or a community mental health center. Also, originating sites must be located in either a non-Metropolitan Statistical Area (non-MSA) or a rural Health Professional Shortage Area (HPSA). In case you were wondering there is no map of MSA’s or HPSA’s.
Assuming that you think your prospective patients meet these criteria, here are some tips on getting reimbursed:
1) Arrange to collect co-pays. Originating site fees are currently reimbursed at $23.35, payable at 80%. The beneficiary at an originating site owes the balance due.
2) If the patient has an Medicare Advantage Plan other than straight Medicare, make sure that clinicians are in that Plan’s panel.
3) For billing, use the correct the Q3014-GT code for ‘originating site’ billing.
4) Hope for the best!
