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|Centers for Medicare and Medicaid Services, USA|
|ScientificTracks Abstracts: J Diabetes Metab|
|There are just over 80 professional physician or practitioner services that may be furnished via telehealth, defined by Medicare as interactive audio and video telecommunications systems that permit real-time communication between a beneficiary at the originating site and the provider at the distant site. These services include 16 nephrology billing codes for furnishing end-stage renal disease services for monthly monitoring and assessment, and two billing codes for chronic kidney disease education. In recent years, many mobile health devices and other web based tools have been developed in support of monitoring, observation and collaboration for people living with chronic disease. However, digital health devices often do not meet telehealth conditions for coverage as currently required under Medicare. The criteria for furnishing telehealth nephrology services, as well as, all other medicare telehealth services are set forth in section 1834(m) of the Social Security Act. Telehealth services are paid under Medicare Part B, when furnished via a telecommunications system that substitutes for an in-person encounter. The presentation will review the statutory and program guidance that govern Medicare telehealth services, defines payment policy terms, (such as originating site and distance site) and clarifies payment policies when telehealth services are furnished, discuss innovation and other technological advancements in telehealth and neprology, and Medicare’s program authority and other statutory inciatives for enhancing the telehealth benefit.|
Stephanie Frilling, MBA, MPH, is currenlty the Program Lead for the Skilled Nursing Facility Value-based Purchaing Program and the Monitoring and Valuation Lead for CMS’s Value Incentives Quality Reporting Programs. As a program lead, she is responsible for overseeing all aspects of regulatory and health policy issuse for these programs, which are opertated by the Centers for Quality Standards and Quality. During her tenure at CMS she has also served as the Program Lead for the End-stage Renal Disease Quality Incentive Program, and as a subject matter expert for the Physican Fee Scheudle and the End-stage renal Disease Prospective Payment System, and has extensive payment experience with Medicare payment and quality programs. Stephanie holds an MBA, MPH and is currently pursuing a Doctrate in Bioethics from Loyola of Chicago.
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