Debbie had the privilege of writing this article for CodingCertification.org, and it was published on their blog on January 12, 2015 (http://www.cco.us/telehealth-changes-coming-2015/).

1. Telehealth – What Is It and What Changes Are Coming In 2015?
What is Telehealth?
Telehealth is the use of technology for the delivery of health care, health information, or health
education at a distance. Although there are several applications used for telehealth, the most popular
applications are teleradiology, continuing professional education, and home monitoring. Teleradiology is
used to send test results to another facility for diagnosis; continuing professional education consists of
presentations given by specialists to general practitioners; and home monitoring is provided by nurses as
a supplement to home visits.
Telehealth consists of two general types of applications. One is
referred to as real-time communication, and the other is called
store-and-forward. Real-time is when a patient and nurse
practitioner consult with a specialist by way of an audio-visual
link, or when a doctor and patient communicate in an exam room
via an interpreter through the phone or webcam. Another
example of real-time communication would be if, say, a
cardiologist holds a teleconference with internists about new best
practices in treating angina. Store-and-forward is when digital
images, such as in radiology or dermatology, are transmitted for
diagnosis.
It is important to note that all telehealth applications require health information technology (IT), but not
all uses of health IT are considered telehealth. Examples of non-telehealth applications would be such
stand-alone systems as electronic health records (EHRs) and computerized decision support (CDS).
In summary, telehealth is a way to increase the communication between a patient and the health system,
and it can also bring more expertise to consult on a case, reaching out to patients when they live far
from the facility. This technology not only eliminates the time it takes to travel, but it also reduces the
expense for both physicians and patients, and is beneficial to improving preventative medicine and the
treatment of chronic conditions.
What Changes Are Coming In Telehealth?
As of January 1, 2015, there will be some major changes that will take effect in telehealth services,
according to the Physician Fee Schedule Final Rule released by CMS. Reimbursement rates will increase
with regard to telehealth services to telehealth originating locations by 0.8 percent. Also, there are
seven new reimbursement codes for 2015 related to telehealth. They include:
•Psychotherapy services (CPT codes 90845, 90846, and 90847)
•Prolonged services in the office (CPT codes 99354 and 99355)
•Annual wellness visits (HCPCS codes G0438 and G0239)
As far as billing is concerned, the originating site fee will be $24.83.
There is also a new CPT code 99490, which permits doctors to bill Medicare for management of chronic
care when a patient has two or more chronic conditions, including heart failure and diabetes. The
monthly, unadjusted, non-facility fee will be $42.60. Since 99490 is a physician service, it is available

2. across the country and is not just for rural telehealth. Therefore, patients are not expected to be present.
CPT code 99490 can be bundled with 99091 for the collection and interpretation of physiologic data,
but CMS still does not allow any further reimbursements for this service. They do, however, allow
providers to count the data review time invested toward the monthly minimum time for billing for
chronic care management.
CMS will also allow two valuable service codes:
•99090 – Analysis of clinical data stored in computers (eg, ECGs, blood pressures, hematologic data).
•99091 – Collection and interpretation of physiologic data (eg, ECG, blood pressure, glucose
monitoring) digitally stored and/or transmitted by the patient and/or caregiver to the physician or other
qualified health care professional, qualified by education, training, licensure/regulation (when applicable)
requiring a minimum of 30 minutes of time.
Remote patient monitoring of chronic conditions will be paid by Medicare with a monthly, unadjusted,
non-facility fee of $56.92 when using CPT code 99091. Previously they only covered services when they
were bundled with evaluation and management codes.
Traditionally, Medicare has provided little coverage for telehealth services. However, this new CMS rule
is a big step and will allow physicians to improve costs and quality of healthcare by using telehealth
technology. Therefore, it is imperative that medical coders and billers understand how to accurately bill
for these services.
By Debbie Jones, CPC-A, CCA
Debbie had the privilege of writing the above article for CodingCertification.org, and it was published on
their blog on January 12, 2015 (http://www.cco.us/telehealth-changes-coming-2015/).
Debbie Jones earned her Associate of Science degree in Medical Billing and Coding from Colorado Technical
University Online, where she received highest honors. Currently pursuing a new career in medical coding, she spends
her time coding real-world cases through CCO's Practicum, attending local Chapter meetings, and is co-administrator of
a Facebook group called Medical Coders Helping Medical Coders. Previously Debbie provided remote medical
transcription services for three years, and prior to that she worked as a secretary/administrative assistant for 12 years.
She lives in beautiful North Carolina where she enjoys spending her free time with family and friends, gardening, home
decorating, and learning all she can about the medical field. She is open to exploring so many different aspects of coding
and healthcare and is eager to discuss them with others.
Debbie can be found on Linkedin, Twitter, and on Facebook.