Diagnosis via Text Message or an iPhone Photo?

Medicare may soon pay physicians to evaluate patients through digital communications technology
By Bruce Japsen

PHYSICIANS MAY soon be able to get reimbursed from Medicare for answering patient text messages and consulting with them for photos they send from their iPhones under a new policy proposed by the Trump administration.

It’s not uncommon for patients to already send their physicians digital communication. And while some commercial health insurers are known to provide reimbursement for such digital consultations as part of risk-based contracts with the health plans, it’s not something they can bill for under Medicare’s fee-for-service program.

But that may change as early as 2019 as the Centers for Medicare and Medicaid Services (CMS) takes steps to reduce paperwork and “increase the amount of time that doctors and other clinicians spend with their patients,” the agency announced in July.

As part of the newly proposed fiscal 2019 physician fee schedule, the Trump administration is proposing to advance “virtual care” as many other commercial insurers have already done, allowing doctors to bill for texts and telehealth consultations. By allowing doctors to bill for a text, CMS administrations see it as a way to cut down on an unnecessary and more expensive trip to a hospital emergency room or other inpatient care. “CMS is committed to modernizing the Medicare program by leveraging technologies, such as audio/video applications or patient-facing health portals, that will help beneficiaries access high-quality services in a convenient manner,” CMS Administrator Seema Verma said.

CMS is seeking public comment on the proposed new rules by September 10.

Under the proposed rule, Medicare would pay clinicians for virtual check-ins which the agency described as “brief, non-face-to-face appointments via communications technology.” In addition, physicians would be paid for “evaluation of patient submitted photos.”

“The proposals deliver on the pledge to put patients over paperwork by enabling doctors to spend more time with their patients,” Verma said. “Physicians tell us they continue to struggle with excessive regulatory requirements and unnecessary paperwork that steal time from patient care. This Administration has listened and is taking action.”