New Medicare Rule Revolutionizes the Way Patients and Providers Communicate

The review of patient-recorded videos and images will be reimbursable in 2019

The U.S. Centers for Medicare & Medicaid Services (CMS) finalized the 2019 Medicare Physician Fee Schedule, which includes several updates that modernize the way providers can use technology to better support their patients.

In particular, CMS created a new billing code, HCPCS G2010, that enables providers to be reimbursed for the review of recorded videos and images sent by their patients. The availability of this new code will dramatically improve the way patients receive care and interact with their providers. Making these interactions reimbursable gives providers the resources to efficiently communicate with patients, assess their condition remotely, and support them throughout treatment.

emocha provided feedback on this code to CMS during the public comment period. We strongly support CMS’ final rule, especially HCPCS code G2010. This will substantially benefit vulnerable patient populations and reduce the costs of healthcare.

Medicare reimbursement for the review of asynchronous videos or images

The new billing code was included in the 2019 Medicare Physician Fee Schedule, a list of services for which providers can be reimbursed. Code G2010 is specifically for the review of videos or images sent asynchronously. Asynchronous — also known as “store-and-forward” — technology in healthcare typically refers to processes by which patients enter data remotely, the data is stored, transferred, and then eventually reviewed by providers. Asynchronous technology makes it possible for care and treatment to take place at times that are convenient for both the patient and provider.

CMS included some requirements in order for providers to be reimbursed through this code. For example:

Providers may only bill this code if they are reviewing a video or image from an established patient.
Follow-up with the patient must take place within 24 hours of reviewing the video. CMS clarified that this follow-up can happen through multiple channels, such as text message, chat, or phone call.
Patients must consent to the review of their data by the provider.
The code may not be billed if the communication is related to an appointment that occurred in the 7 days before — or within 24 hours after — the video was submitted.

There are limitless opportunities to use asynchronous technology to support patients. For example, providers may use this code to help patients who may be struggling to adhere to their treatment regimens, particularly when providers suspect that medication adherence is a challenge. Asynchronous technology can also be used to determine if patients are experiencing symptoms or side effects, such as if a person appears to have jaundice. Videos or images sent asynchronously could also be beneficial for wound care and dermatology. By keeping the potential uses open, CMS allows providers to discover innovative uses of asynchronous technology that reduce costs while improving patient care.

Medicare reimbursement for communication technology

The new code, G2010, and others included in the 2019 Medicare Physician Fee Schedule, may incentivize providers to use technology to efficiently communicate and care for patients remotely. For example, code G2012 enables providers to be reimbursed for real-time communication (e.g., phone calls or video chats) with patients to determine if they need an appointment. Additionally, Rural Health Centers and Federally Qualified Health Centers will now have their own code, known as G0071, that will reimburse providers in these settings for the review of asynchronous photos or videos and real-time communication with patients to determine if an appointment is needed. Separate reimbursement codes for remote patient monitoring technologies and telehealth services are also available.

These codes mark a significant shift in the way that Medicare views the use of technology to support patients. By providing reimbursement, CMS is signaling that providers should use modern communication tools to facilitate interactions with their patients and efficiently engage them in care.

Medicare often serves as a reference for the services that private insurance companies and Medicaid cover. Thus, the inclusion of G2010 and other codes in the 2019 Medicare Physician Fee Schedule is a signal to the healthcare industry that asynchronous video and other communication technologies are highly valuable tools in caring for patients. Some states, such as California, have already proposed plans for similar reimbursement.

We look forward to working with patients, their care teams, and health insurers to ensure patients are supported through treatment with the use of asynchronous technology.