Author response: COVID-19 is catalyzing the adoption of teleneurology
Brad C.Klein, Neurologist, Abington Hospital, Department of Neurology, Thomas Jefferson University
Neil A.Busis, Neurologist, NYU Langone Health, Department of Neurology
Submitted April 21, 2020
We thank Dr. Sethi for his thoughtful comments on our editorial1 and on new rules, regulations and policies that encourage the use of telehealth during the COVID-19 pandemic and complexities of telehealth reimbursement.2 Although telehealth increases access to care and has a growing evidence base,3,4 the primary driver for rapid deployment during the COVID-19 pandemic is ensuring safety by social distancing.
The current reimbursement system for telehealth consists of modifications of pre-existing codes designed to lower the barriers to virtual encounters. Most of the recommended codes were designed for face-to-face evaluation and management (E/M) services and can now also be used for virtual encounters with the proper modifiers.2,5 Other codes were always designed to be non-face-to-face codes, such as the telephone E/M codes.2,5 They have built in restrictions aimed at preserving the primacy of face-to-face services, which have not been rescinded.2,5
The COVID-19 pandemic has forced patients, providers, policymakers, and payers to rethink how health care should be delivered. Since telehealth is effective in a range of clinical situations, we hope the current favorable environment for telehealth will not change substantially after the COVID-19 pandemic is controlled.1,3,4 We further hope that future reimbursement systems will be streamlined and more clinically meaningful.1,2
Disclosure
The author reports no relevant disclosures. Contact journal@neurology.org for full disclosures.
References
Klein BC, Busis NA. COVID-19 is catalyzing the adoption of teleneurology. Neurology 2020 Epub Apr 1.
Cohen BH, Busis NA, Ciccarelli L. Coding in the World of COVID-19: Non–Face-to-Face Evaluation and Management Care. In: Continuum: Lifelong Learning in Neurology. In press 2020 Epub 2020 Mar 27. Available at: https://cdn-links.lww.com/permalink/cont/a/cont_2020_03_26_coding_2020-1.... Accessed April 20, 2020.
Dorsey ER, Glidden AM, Holloway MR, Birbeck GL, Schwamm LH. Teleneurology and mobile technologies: the future of neurological care. Nat Rev Neurol 2018;14:285–297.
Hatcher-Martin JM, Adams JL, Anderson ER et al. Telemedicine in neurology: Telemedicine Work Group of the American Academy of Neurology update. Neurology 2020;94:30–38.
CPT manual: American Medical Association. CPT 2020 Professional Edition. Chicago: American Medical Association; 2019.
We thank Dr. Sethi for his thoughtful comments on our editorial1 and on new rules, regulations and policies that encourage the use of telehealth during the COVID-19 pandemic and complexities of telehealth reimbursement.2 Although telehealth increases access to care and has a growing evidence base,3,4 the primary driver for rapid deployment during the COVID-19 pandemic is ensuring safety by social distancing.
The current reimbursement system for telehealth consists of modifications of pre-existing codes designed to lower the barriers to virtual encounters. Most of the recommended codes were designed for face-to-face evaluation and management (E/M) services and can now also be used for virtual encounters with the proper modifiers.2,5 Other codes were always designed to be non-face-to-face codes, such as the telephone E/M codes.2,5 They have built in restrictions aimed at preserving the primacy of face-to-face services, which have not been rescinded.2,5
The COVID-19 pandemic has forced patients, providers, policymakers, and payers to rethink how health care should be delivered. Since telehealth is effective in a range of clinical situations, we hope the current favorable environment for telehealth will not change substantially after the COVID-19 pandemic is controlled.1,3,4 We further hope that future reimbursement systems will be streamlined and more clinically meaningful.1,2
Disclosure
The author reports no relevant disclosures. Contact journal@neurology.org for full disclosures.
References