As of Jan. 1, 2009, eligible originating sites for payment of telehealth services will include hospital-based or critical access hospital-based renal dialysis facilities (including satellites), skilled nursing facilities and community mental health centers. This amendment to the Social Security Act is mandated by the Medicare Improvements for Patients and Providers Act (MIPPA) of 2008.
In addition to the three new sites, qualified originating sites are:
Physician’s or practitioner’s office
Critical access hospital (CAH)
Rural health clinic
Federally qualified health center
Independent renal dialysis facilities are not eligible originating sites and do not qualify for payment of telehealth services.
An originating site is the location of an eligible Medicare beneficiary at the time the service is furnished via telecommunications.
The originating site facility fee is a separately billable Medicare Part B payment. Payment is not based on the Outpatient Prospective Payment System (OPPS). The update fee is included in the Medicare Physician Fee Schedule (MPFS) final rule.
When the originating site is a physician’s or practitioner’s office, the payment amount is the lesser of 80 percent of the actual charge or 80 percent of the originating facility fee, regardless of geographic location.
For more details, read CMS Transmittal 97, Change Request 6215, released Nov. 14.