Magazine article Clinical Psychiatry News

Reimbursement Urged for Certain E-Mail Consults. (CMS against Separate Payments)

Magazine article Clinical Psychiatry News

Reimbursement Urged for Certain E-Mail Consults. (CMS against Separate Payments)

Article excerpt

SAN DIEGO - The American College of Physicians is calling on Medicare and private insurers to reimburse physicians for certain types of e-mail consultations. Some private insurers already have begun to pay their physicians for e-mail consultations, but Medicare seems reluctant to pursue this option for physicians.

The major barrier to physicians using email consultations is the lack of reimbursement for this service by insurers, the ACP concluded in a new policy paper, "The Changing Face of Ambulatory Medicine: Reimbursing Physicians for Computer-Based Care."

ACP officials expounded on the technology's benefits during a press briefing at the college's annual meeting.

"There is a wide spectrum of nonurgent patient conditions that could be effectively managed without the time and expense of an office visit, through a carefully structured e-mail consult system focused on established patients," said Dr. Sara Walker, immediate past president of the ACP.

This would avoid wasted hours playing telephone tag, improve documentation of physician-patient interaction, and increase physician time when face-to-face visits are necessary

An estimated 20% of the 830 million annual office visits per year could be eliminated by online communications between clinicians and patients, the ACP paper said, citing statistics from "HealthCast 2010," a report released in 1999 by PricewaterhouseCoopers.

The ACP recommended that e-mail consultations be reimbursed as a separate service outside of the usual evaluation and management service. Specific examples of reimbursable e-mail consultation services would include:

* Services that involve a new diagnosis or treatment.

* Follow-up maintenance services.

* Treating relapses of a previous condition that could be adequately assessed by e-mail but would require a significant investment of time and judgment.

* Reporting laboratory test results that require a significant change in medication or further diagnostic tests.

* Consultation regarding a nursing or rest home patient who has a significant change in condition.

* Extended personal counseling of a patient who has previously been evaluated for a psychiatric problem in the office, and is stable.

* Extended counseling with family.

* Answering questions about preventive health and interpreting literature that the patient has found in a magazine or on the Internet.

The ACP also recommended Medicare coverage and payment for the new CPT code 99091 to compensate physicians for review of computer-transmitted patient medical data for diagnostic and/or treatment purposes. …

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