OIG reviewed 191,118 Medicare paid distant-site telehealth claims, totaling $13.8 million, that did not have corresponding originating-site claims. The watchdog agency then reviewed provider supporting documentation to determine whether the services met Medicare’s requirements for reimbursement. 31% of the telehealth claims did not. Specifically:
24% were unallowable because the beneficiaries received services at nonrural originating sites
7% were billed by ineligible institutional providers
3% were for services provided to beneficiaries at unauthorized originating sites
2% were for services provided by an unallowable means of communication
1% was for a noncovered service
1% was for services provided by a physician located outside the United States
Understand Medicare telehealth requirements—including coverage, coding, and documentation rules—and ensure your telehealth program and claims comply.
Bank on TCI’s all-new, end-to-end Telemedicine & Telehealth Handbook for Medical Practices 2018 to equip you to plan and implement your telehealth services, weigh the cost of care and technology, and master payment aspects, compliance, and other legal requirements.
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Are You Eligible for a Geographic Waiver?
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Make the Grade with These Consumer-Centered Telehealth Design Principles
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Telehealth Services Arranged Alphabetically by Code Descriptor
Telehealth Services Ordered Numerically by Code Number
Glossary of Telemedicine and Telehealth Terminology
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