The absence of consistent, comprehensive reimbursement policies is often cited as one of the most serious obstacles to total integration of telehealth into health care practice. The lack of an overall telehealth reimbursement policy reflects the multiplicity of payment sources and policies within the current United States health care system. The vast majority of health care costs are paid by private insurers, Medicare, and Medicaid.
CTeL conducted a 50 state survey which reviewed each state’s telehealth reimbursement policies. CTeL’s research found that 39 states have some type of reimbursement for services provided via telehealth.
There are many factors that states use to determine the scope of coverage for telehealth applications, such as the quality of equipment, type of services to be provided, and location of providers (e.g., remote rural sites).
Medicare is the federal health insurance for America’s senior citizens. Most of the financing and reimbursement for telehealth services comes from Medicare. The expansion of Medicare reimbursement began when Congress passed the Balanced Budget Act of 1997 (BBA), which mandated that Medicare reimburse telehealth care and fund telehealth demonstration projects.
How to Determine If Your Site Is “Rural”
In consultation with the Health Resources and Services Administration (HRSA) and the Centers for Medicare and Medicaid Services (CMS), The Robert J. Waters Center for Telehealth and e-Health Law (CTeL) can provide a streamlined method to determine “rural” eligibility.