As COVID-19 spreads through our communities, there are steps you can take to minimize contactwith patients. A primary step is to implement telemedicine. TMA has developed some quick tips to help you get started.
Insurers to Cover Visits Governor Abbott waived certain regulations and directed the Texas Department of Insurance (TDI) to issue an emergency rule relating to telemedicine provided through state-regulated insurance plans. Contracted or preferred physicians and other health care professionals will be eligible for payment from TDI-regulated insurance plans for medical visits they conduct over the phone instead of in person at the same rate they would receive for in-person visits.
HIPAA Restrictions Suspended Effective immediately, the U.S. Health and Human Services (HHS) Office for Civil Rights will not penalize physicians for noncompliance with HIPAA when they serve patients in good faith through common, nonpublic-facing communications technologies, such as FaceTime or Skype.
Medicare Telehealth Expands The Centers for Medicare & Medicaid Services (CMS) has temporarily broadened telehealth access to Medicare patients. Medicare can pay for office visits furnished via telehealth in all areas of the country (not only rural areas) and in any setting, including in a patient’s home. Physicians may reduce or waive cost-sharing for telehealth visits paid by federal health care programs.
Learn More About These Changes
The following list reveals the key functionality of the various telemedicine products as reported by the vendors on their own websites. TMA has not vetted these companies but wanted to provide information for physicians seeking to implement telemedicine into their practice. This list is not exhaustive and is separated by companies offering stand-alone products and those that have electronic health record (EHR) integrations.
Be sure to execute a business associate agreement with the telemedicine vendor.
View the Vendor Details
Telemedicine has the opportunity to transform a physician’s practice. As the service becomes more readily available through health plans and employers, patients are expecting more from their own physician. It makes sense for a patient to have the choice to see their own doctor for continuity of care and comfort in times of illness and uncertainly.
TMA created this evaluation tool to help Texas physicians with some of the criteria to consider in the selection of telemedicine vendor products.
See the Telemedicine Vendor Evaluation Criteria
The announcement late last month that Medicare will pay for audio-only telehealth visits at the same rate as similar in-person visits was a welcome change for physicians in light of the rapid growth of telemedicine.
The fact that it would be retroactive to March 1 was even better news considering the number of practices struggling with decreased revenue and reduced in-person patient visits.
But one question has remained unanswered: whether Medicare Administrative Contractors (MACs) will automatically reprocess those already-submitted claims, or if physicians will need to resubmit them.
As you are probably aware, many state and federal rules and regulations regarding telehealth have changed or been relaxed during the COVID-19 pandemic, including what types of telehealth visits will be covered, and which plans pay for what types of visits.
So to help you literally navigate telemedicine coding, the Texas Medical Association created a flow chart that starts at the type of encounter and ends at what codes to use.
Physicians can temporarily use telemedicine for Texas Health Steps (THSteps) medical checkups of children older than 24 months, the Texas Health and Human Services Commission (HHSC) announced Friday.
The guidance, which applies to both new and established patients, is effective until May 31. It is applicable for both managed care and fee-for-service Medicaid.
In the wake of COVID-19, TMA is getting calls about which payers are covering telemedicine. TMA developed this quick reference guide to help you navigate telemedicine reimbursement. This table now reflects Medicare’s waiver of the geographic and place of service restrictions for Medicare (which means patients can now be at home).
Additionally, the Governor directed TDI to issue an emergency rule related to the payment of telemedicine to allow state-regulated plans (about 20% of the commercial market in Texas) to allow telephone and telemedicine visits to be paid at the same rate as in-office visits. If you are not sure which patients are regulated by TDI, check this guide. Stay tuned for more detail.
Updated May 18, 2020
Administration and Billing
The laying on of hands has traditionally defined the patient-physician relationship, but the expanded use of telemedicine during the COVID-19 pandemic has challenged this long-held belief.
Physicians and patients alike are becoming more comfortable with visiting virtually and using technology to connect and share information.
Remote patient monitoring is another aspect that can enhance the effectiveness of and satisfaction with telemedicine.
As you adapt to telemedicine visits, your patients do, too. There are many aspects of a telemedicine visit your patients may feel uncertain about or have not considered.
TMA developed a Telemedicine Visit Tips reference sheet, designed to help your patients prepare for a telemedicine visit. You can customize the document for your practice and your patients. You may choose to add information specific to your telemedicine platform that addresses the technology questions you frequently receive from your patients.
To make telemedicine more available, many state and federal rules and regulations regarding telehealth have changed temporarily during the COVID-19 public health emergency, including payments for certain types of visits.
That’s all good news if you or your practice is struggling financially because of decreased in-person patient visits. But it doesn’t mean much if your patients don’t know about it.
The COVID-19 pandemic has made telemedicine the way to see and consult with all patients, not just those who have confirmed or suspected cases.
To make telemedicine available to more patients and their physicians during the emergency declaration period, many state and federal rules and regulations regarding telehealth have changed
The use of telemedicine has been expanded so physicians can safely and effectively treat patients during the COVID-19 pandemic.
However, some people don’t have smartphones with video capability, meaning visits will have to be done via old-fashioned phone calls.
Which health plans cover telephone-only patient visits, and what exactly do they pay for?
Like a stage actor who comes across awkward on a television or movie screen, you might find it challenging to connect with your patients during video telehealth visits.
When using telemedicine, the physician “is stepping into the patient’s environment,” says mHealthIntelligence. This can change the dynamics of the patient-physician relationship.
The U.S. Drug Enforcement Administration (DEA) will allow physicians to issue prescriptions for all schedule II-V controlled substances via telemedicine as long as specific conditions are met.
The Texas Medical Association (TMA) joined The Physicians Foundation, American Medical Association, Florida Medical Association, and Massachusetts Medical Society in launching The Telehealth Initiative to help physicians start telehealth care. With the current health crisis, the organizations sped the initiative’s launch to help physicians shift to telehealth to meet patients’ needs from their homes where they cannot transmit COVID-19 or other diseases to other people.
How well do you understand Texas’ laws and regulations relating to telemedicine? This document describes the new Texas legal and regulatory requirements that apply to a physician providing telemedicine medical services.
This white paper was updated in August 2019.
Don't miss out on free CME for TMA members. This publication qualifies for 1.5 AMA PRA Category 1 Credits™.
Read the White Paper
A growing number of physicians are embracing telemedicine.
Because most physicians still have no first-hand experience with it, they have many questions about how it will help them and their patients.
Telemedicine is rapidly evolving, and the number of physicians who use it continues to grow.
Whether you use telemedicine every day in your practice or you’re just starting to consider how it might benefit your patients, you probably have plenty of questions and concerns about using it effectively and within compliance.
That’s why the Texas Medical Association formed a task force that will help TMA serve physicians who want to integrate telemedicine into their practice.
Texas Medical Board FAQs Regarding Telemedicine During COVID-19 Crisis
Telehealth Remote Communications During COVID-19 - HHS.gov
Medicare Telehealth FAQs re: COVID-19 - CMS
Medicare Telemedicine Health Care Provider Fact Sheet - CMS
Go to the TMA COVID-19 Resource Center
Telemedicine During COVID-19 – Listen to this webinar to learn telemedicine terminology and the CMS changes, such as what codes you can bill during this time. On Demand WebinarCME to GoPodcast
Quick Tips: Getting Started in Telemedicine – Incorporate telemedicine amid COVID-19.CME to GoPodcast
Telemedicine: The Changing Shape of Care – Explore the practice benefits of telemedicine.On Demand Webinar
TMA members are eligible for a free technology contract review from Coker Group – including a contract review of telemedicine vendor services. Evaluations focus on potentially unfavorable terms with feedback on identified concerns.
Submit Your Contract
View this free webinar for a general look at telemedicine and virtual visits and how they may benefit your patients.
View the TMA Webinar
Have questions about telemedicine? Call or email the Knowledge Center.