Telehealth Community Urged to Take Grassroots Action on OAT Funding

Congress is currently in the process of drafting appropriations legislation to provide federal spending for fiscal year (FY) 2009, which will begin on October 1st of this year. Last year, the telehealth community galvanized a strong grassroots advocacy campaign in support of increasing funding for the Office for the Advancement of Telehealth (OAT). Hundreds of individuals and institutions contacted Congress urging that OAT funding be increased. These grassroots efforts resulted in the Senate voting to approve an amendment boosting OAT funding from $6.8 million to $13.8 million. While this increase was unfortunately not retained in compromise negotiations with the House of Representatives, the Senate vote was proof that Congress will act to support telehealth when they hear from constituents in their states and districts. Members of the telehealth community are urged to reach out to Congress and urge that telehealth receive the support it deserves. A $13.8 million budget for OAT will significantly advance telehealth in the United States. If you are willing to have your name added to the list of those supporting an increase in telehealth funding, please send an email to info@telehealthleadership.org including your name, title, organization, and address. This information will be used to add your name to the letter. Please also contact your two senators and urge them to add their names to a joint letter being circulated by Sen. Debbie Stabenow of Michigan and Sen. John Thune of South Dakota urging that telehealth funding in the FY 2009 Labor-HHS bill be raised to $13.8 million. With the telehealth communities grassroots efforts, funding for this critical telehealth agency can be increased. (Source: Bob Waters, Partner and Chair, Telehealth, E-Health Law & Government Relations Groups Drinker, Biddle & Reath, March 21, 2008)

Medicare Reimburses for Neurobehavioral Telehealth Exams

The Centers for Medicare & Medicare Services (CMS) recently announced in that the neurobehavioral status exam (Healthcare Common Procedure Coding System (HCPCS) code 96116) has been added to the list of Medicare telehealth services. Previously, CMS determined that, if the eligibility criteria, and conditions of payment are satisfied, the use of a telecommunications system may substitute for a face-to-face, "hands on" encounter for consultation, office visits, individual psychotherapy, pharmacologic management, psychiatric diagnostic interview examination, end stage renal disease related services, and individual medical nutrition therapy.

When billing this code as a Medicare telehealth service, you must append modifier GT ("telehealth service via interactive audio-video telecommunication system"), and all other criteria for telehealth reimbursement under Medicare must be met as set forth in the Medicare Benefit Policy Manual (Publication 100-02, Chapter 15, Section 270) and the Medicare Claims Processing Manual (Publication 100-04, Chapter 12, Section 190).

HCPCS code 96116, neurobehavioral status exam, involves clinical assessment of thinking, reasoning and judgment per hour of a psychologist's or physician's time.