By: Jennifer M. Smith, Esq.
Telemedicine, or “telehealth,” has a promising future in the workers’ compensation arena. More providers are offering these services, (notably Concentra and U.S. Healthworks launched telemedicine programs last year), and the prevailing thought is that use of telemedicine has the potential to decrease costs and improve patient satisfaction, resulting in better overall outcomes for both the insurer and the employee. Telemedicine can be an efficient answer to injured workers with mobility issues or who live in remote areas with limited access to specialists. Telemedicine can prevent unnecessary ER visits after hours, provide convenient follow up care and reduce mileage reimbursement costs. On the surface, telemedicine looks like a no-brainer. However, there are many factors to consider, including licensing, determination of appropriate conditions to treat via telemedicine and reimbursement issues, before approving telemedicine for workers’ compensation claims. It is for these reasons that few states have actually adopted telemedicine into their fee schedules. Many states, including Georgia, are closely reviewing telemedicine to add reimbursement in the near future, however.
One issue the Georgia State Board is looking at is whether a provider can add an “equipment” fee along with the telehealth service provided to the patient. This fee would help pay for the electronic devices needed for the doctor to provide telemedicine. Another issue is whether evaluation and management services provided via telemedicine would be at a reduced reimbursement amount since the costs for the provider are presumably less. In addition, providing services across state lines and other limitations are being reviewed. The Georgia Composite Medical Board enacted Rule 360-3-.07 in 2014 governing standards for telemedicine practice which include the requirement that all telehealth treatments must be conducted by Georgia licensed providers and that prior to the telemedicine encounter the provider must have personally conducted an in-person examination with a few exceptions (use of technology which is equal or superior to an in-person examination or the provider is evaluating the patient at the request of another provider who has examined the patient in-person).
The 2018 Georgia Workers’ Compensation Fee Schedule will be effective April 1, 2018. Telemedicine reimbursement is not going to be included in this year’s fee schedule although it is possible the Board could add an amendment later this year if the decision is made to reimburse telemedicine services prior to the release of the 2019 Fee Schedule next April. We will update you if this is the case.