Telehealth Service Eligible for Reimbursement Effective January 1

According to the New York State Department of Health, qualifying services delivered via telehealth will be eligible for reimbursement by commercial insurers and the Medicaid program effective January 1, 2016.

The state defines telehealth as “the use of electronic information and communication technologies to deliver health care to patients at a distance, which shall include the assessment, diagnosis, consultation, treatment, education, care management and/or self-management of a patient.” Impediments to care such as access to a specialist or distance/time concerns could be mitigated through the use of this service.

“A patient can consult with a specialist in Saratoga via their local practitioner’s office in Plattsburgh,” said Caitlyn Huntington, AHI Telehealth Coordinator. “A patient is much more likely to seek care locally than commit to traveling four-hours round trip.”

The state expanded eligibility to providers beyond physicians, encompassing midlevel providers such as nurse practitioner, social worker, and midwife.

“In a region understaffed by specialists, this is a great boon,” said Huntington. “A psychiatric nurse practitioner or social worker can meet a patient’s needs in a timely manner.”

The reimbursement level for a telehealth session equates to an office visit. A patient can visit their local practitioner, and follow the standard intake procedure with a nurse taking vitals. They would then be connected to a provider at a distant site.

Implementation Challenges

According to Huntington, AHI partners are embracing telehealth. Now that reimbursement is available the cost of equipment can be the biggest hurdle as an investment can range from $5,000 to $100,000 or more depending on the type of equipment and software needed. Huntington cited possible support via a USDA telemedicine equipment grant that could be announced as early as next month.

AHI Support

AHI supports our nine-county region by connecting funding, training, and best practices to regional partners. Activities include:

  • Seeking grant funding opportunities;
  • Establishing telehealth user collaborative meeting;
  • Serving as a resource;
  • Developing a webinar series on telemedicine implementation and program planning;
  • Collaborating with ACTION (Adirondack Champlain Telemedicine Information Network), a seven county consortium established to bring broadband to the Adirondacks. The group leverages connections with telecommunications providers.

More Information

Contact Caitlyn Huntington at [email protected].

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