Medicare Approves Separate Payment of Pre-Recorded Images or Videos Information
In 2019 CMS will start paying a small amount to clinicians for reviewing video and/or images captured by a patient or caregiver. The video/image should be used by the provider to determine whether an office visit or other service is warranted. Medicare is currently limiting this to established patients. Reimbursement will be through HCPCS code G2010, and the reimbursement will be approximately six to seven dollars (the Work RVU is 0.18).
However, currently there is no reimbursement available for viewing previously recorded images or video center providers outside the context of the office visit. This code may be more impactful to certain specialties such as dermatology and ophthalmology, but it is not limited to any specialty. It may also provide additional motivation for clinicians to encourage patients to forward videos or images that lead to needed interventions or reassurance (Actinic Keratosis shown in image above).
The description for code G2010 is:
“Remote evaluation of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related E/M service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment.”
Guidelines for use of HCPCS code G2010 are provided in the 2019 Physician Fee Schedule/Quality Payment Program Final Rule released on November 1, 2018. They include:
The service is applicable to established patients only. The clinician or group needs to have an established relationship with the patient, and the patient needs to have been seen by a practitioner within the same specialty or subspecialty within the last three years.
- There has been no previous E/M office visit within the previous seven days of the remote service being provided.
- The remote service does not lead to an E/M office visit or procedure within 24 hours or the soonest available appointment.
- The billing clinician must respond to the video and/or image by communicating with the patient within 24 business hours. This may be through a phone call, audio/video communication, secure text messaging, email, or patient portal communication.
- The patient needs to provide consent for receiving the service. They need to be informed that they are responsible for the 20% co-pay for the encounter, which will be in the range of $1.60. Consent can be attained verbally or through electronic or paper correspondence, however it must be included in the medical record.
- CMS anticipates that clinicians will request patients to resend videos or images that are of poor quality but regardless will not bill for this service if adequate quality videos or images are not available.
Addendum: Overview of documentation requirements
- The confirmed identity of the patient using as much demographic information as necessary.
- The date and time the video and/or image was received.
- Relevant clinical history as appropriate.
- Findings specific to the video and/or image, including image quality.
- Communication with the patient in follow-up after reviewing the image, when this occurred, and the date and time the follow-up communication occurred..
- The final disposition and that reviewing the video and/or image did not lead to an E/M office visit within 24 hours or at the next available appointment.
- The patient had not been seen for an office E/M visit within the past seven days with the same provider or with a provider in the same subspecialty within a group practice.
For questions or additional information please contact the author (Michael Stearns, MD, CPC, CFPC) at Michael@ApolloHIT.com
Image Source: Wikipedia