Medicare Policies

Medicare Policy Resources

Resources are in .pdf format and may be printed. To view/download, click the resource titles.

Medical Learning Network Booklet Telehealth Services

CPT codes, descriptions and other data.

List of services payable under the Medicare Physician Fee Schedule when furnished via telehealth

CMS provides a list of payable telehealth services under Medicare Physician Fee Schedule

Medicare Claims Processing Manual – Chapter 12: Physicians/Nonphysician Practitioners (Rev. 2194, 03/25/14)

Chapter 12 of the Medicare Claims Processing Manual provides claims processing instructions for physician and nonphysician practitioner services. Included in the manual is a section highlighting Medicare Payment for Telehealth Services (Sec. 190, pgs. 190-205).

Expansion of Medicare Telehealth Services for CY 2014

This article is based on Change Request (CR) 8553, which updates Medicare telehealth services in the “Medicare Benefit Policy Manual” and the “Medicare Claims Processing Manual.

CMS Final Rule Summary for CY 2014

On December 2, 2013, CMS released its final rule on their July 19, 2013 proposed changes to the Medicare Program’s definition of “rural” HPSAs as it relates to telehealth. Please click link above to see PBTRC’s summary of this Final Rule as well to check your eligibility status for reimbursement for telehealth services under Medicare.

Program Memorandum: Revision of Medicare Reimbursement for Telehealth Services (05/01/01)

On May 01, 2001, the Department of Health and Human Services (DHHS) Health Care Financing Administration (HCFA) released a Program Memorandum outlining the Revisions of Medicare Reimbursement for Telehealth Services. These revisions included updates to: eligibility criteria, coverage of telehealth, conditions of payment, payment methodology, claims submissions, and more.