Telemedicine Billing One Year Later – Where are we?

When COVID hit telemedicine was something that was only allowed in rural areas, or areas where patients had limited access to medical care.  But COVID made telemedicine a necessity.  Providers and billers were scrambling to figure out how to bill for telemedicine and insurance carriers were scrambling to figure out how to allow for it. 

Once COVID-19 hit the united states nany medical office were forced to temporarily close.  No one knew (at that time) how long these closures would last.  Most primary care doctors remained open but were only seeing patients with urgent conditions.

Most specialty offices such as eye doctors, physical therapists, urologists, dermatologists, chiropractors and others were forced to close.  The problem was that patients still had other conditions that required treatment.  Disease didn’t stop due to COVID-19.  People still had high blood pressure, diabetes, conjunctivitis, cancer, etc.  When the closures were first announced it was implied that it would only last for a couple of weeks.  But very quickly it became evident it would be longer.

Insurance carriers were forced to change coverage guidelines.  Patients needed to be seen.  Especially patients seeking outpatient mental health care.  Mental health services have been steadily increasing throughout the last several years.  COVID-19 caused many more Americans to seek mental health care.  Patients that were already in treatment needed to continue being seen, and these new patients also needed to be seen.

Insurance carriers and providers had to find a way to provide medical care to patients while protecting both patient and provider.  In cases where patients had no choice but to see providers in person, they had to rely on protective gear such as masks, shields and gloves.  But in cases where a patient did not have to be seen in person, telemedicine made the most sense.

Insurance carriers that previously covered telemedicine, but with restrictions, basically lifted those restrictions.  Insurance carriers that did not previously cover telemedicine began allowing it immediately.  Some carriers even went as far as to cover the patients’ responsibility.  For example, if a patient saw a psychologist pre-COVID-19 and had a $25 copay but now saw the same psychologist for a telemedicine visit after March of 2020, they would pay the entire allowed amount.  The patient would not have to pay the $25 copay and the provider would be reimbursed for the entire allowed amount.

So where are we one year later?  Telemedicine is still very much being utilized, especially in the mental health field.  Vaccinations have started, and the infection rates are way down, but some patients are still high risk, or just afraid to expose themselves.  Insurance carriers are still allowing providers to utilize telemedicine.  Honestly, in my opinion I think telemedicine is here to stay at least on some level. 

Many providers were already pushing for telemedicine prior to COVID.  It is utilized in other countries and by insurance carriers.  I believe COVID pushed us forward in this area and now that we’ve arrived we won’t be looking back.  Face it, telemedicine can be very effective.  There are many medical visits missed each year because patients don’t feel well, don’t have transportation,  don’t have a babysitter, or many other reasons.  With a telemedicine option there won’t be as many cancelled appointments or missed appointments.  It can also allow providers to practice more efficiently. 

Of course there are certain fields and certain medical conditions that require face to face contact.  But there are many other situations where telemedicine works great.  With the way life is today, between COVID and simply the craziness of life telemedicine can make things easier on both ends.  I don’t believe it will be going away anytime soon!