Telemedicine Coverage and Payment Parity

Posted on June 14, 2016 I Written By

John Lynn is the Founder of the blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of and John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I recently heard Nathaniel Lacktman from Foley & Lardner LLP give the best presentation on telehealth I’d ever seen. I’d never heard someone so familiar with the challenges and laws associated with telehealth. In fact, with that in mind, I’m hoping to get him on a Healthcare Scene interview in the future.

One of the key things he said about telehealth is the need for: Coverage and Payment Parity.

I thought it was the perfect synopsis of what’s holding telehealth back. If we had telehealth insurance coverage and payment parity, then telehealth services would go through the roof! Although, it’s worth pointing out that you need both of these things.

One problem I’ve seen with many telehealth initiatives is that a telehealth visit is treated like a second class citizen. Why would a doctor want to do a telehealth visit if they aren’t getting paid the same? This is why payment parity is so important and hasn’t been addressed nearly enough in the telehealth laws that have been passed.

The real question is why shouldn’t a telehealth visit be paid the same? If you’re able to document and code the telehealth visit to the same level as you would an in-person visit, why would we pay a doctor less for doing the same type of visit, just virtually?

There are a few states where they’re making progress with coverage and payment parity. It’s too bad we don’t have a national effort to get this in place. Telehealth is not the end all be all. It won’t replace all in-person visits to your PCP, but it could replace a lot of them. Plus, it will encourage a lot of early interventions that would have been delayed because a patient didn’t want to go to the hassle of an in-person visit to the doctor’s office.