DMAS Coverage of Telemedicine

1
DMAS Coverage of Telemedicine

• Presentation to
• The Medicaid Physician Advisory Committee

Department of Medical Assistance Services
July 15, 2003
2
DMAS Coverage of Telemedicine

• Telemedicine is the real-time or near real-time
  two-way transfer of medical data and information
  using an interactive audio/video connection for
  the purposes of medical diagnosis and treatment.
  
• Typically, the patient is under the care of a
  medical practitioner at a rural spoke site and
  telemedicine is utilized with a practitioner at a
  hub site a considerable physical distance away.
  

3
DMAS Coverage of Telemedicine

• DMAS Pilot Project Started in 1995
• Hub Spoke
• MCV Blackstone Family Practice
• UVA Thompson Family Health Center (Van
  Sant), others
• Southwestern Va. Ten Community Services Mental
  Health Inst. Boards

4
DMAS Coverage of Telemedicine

• Telemedicine Services Covered under the Pilot
  Project
• Some consultations
• One psychotherapy service
• Limited number of clinical services in cardiology
  and colposcopy
• Only physicians recognized as providers.
• DMAS is one of about 18 Medicaid programs
  covering telemedicine.

5
DMAS Coverage of Telemedicine

• DMAS Interests in Telemedicine
• Improved patient access to medical services
• Improved patient compliance with treatment
  regimens
• Medical services rendered at an earlier stage of
  disease, improving long-term patient outcomes
• Reduction in DMAS expenditures such as for
  hospitalizations and transportation

6
DMAS Coverage of Telemedicine

• DMAS Telemedicine Coverage Expansion
• Started July 1, 2003
• Statewide
• Additional Services Covered
• Office visits
• Individual psychotherapy
• Full range of consultations

7
DMAS Coverage of Telemedicine

• Providers Recognized by DMAS for Telemedicine
• Physicians
• Nurse practitioners
• Clinical psychologists
• Clinical social workers
• Licensed professional counselors

8
DMAS Coverage of Telemedicine

• DMAS Reimbursement Process
• Hub practitioner bills for services such as
  consultation
• Spoke practitioner bills a special telemedicine
  code
• DMAS billing codes are HIPAA compliant
• Coverage estimated as budget-neutral
• DMAS coverage similar to Medicare
• DMAS will be notifying providers through a
  mailing. Coverage description will be included in
  provider manuals.