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CMS Releases New mHealth Codes for 2019

mHealth codes 2019 CMSBy: Amanda Bhikhari

Improving patient outcomes while maintaining physician decision making and practice efficiency is key to success in the growing health care arena. Innovation is the ability to see change as an opportunity to create new value, instead of a threat to what we find comfortable. It is clear that the Center for Medicare and Medicaid Services (CMS) is embracing the importance of innovation in the way we deliver health care.

In November 2018, the 2019 Physician Fee Schedule and Quality Payment Program was released by CMS with changes effective January 1, 2019.  This is the time for providers to definitely keep their eyes open to utilizing mHealth, and telehealth services. mHealth is also known as mobile health, and is a general term for the use of mobile phones and other wireless technology in medical care to educate consumers about preventive healthcare services as well as for disease surveillance, chronic disease management, treatment support, epidemic outbreak tracking. The release of the program is a sign that the agency is in favor of expanding the implementation of technology in providing medical care.  The updated mHealth codes are:

  • HCPCS code G2012 – Brief communication technology-based service, e.g. virtual check-in and
  • HCPCS code G2010 – Remote evaluation of recorded video and/or images submitted by an established patient

The new rules expand reimbursements for providers using remote patient monitoring platforms, as well as those using telehealth technology for virtual check-ins. In a nutshell, the program allows practitioners to be separately paid for a brief communication technology-based service when the patient checks in with the practitioner via telephone or other device to determine if an office visit or other service is needed. This would mean greater efficiency for practitioners, financial savings, and convenience for patients.

Also, the service of remote evaluation of recorded video and/or images submitted by an established patient would allow practitioners to be separately paid for reviewing a patient-transmitted photo or video information conducted via pre-recorded “store and forward” video or image technology to assess whether a visit is needed.

When providers and Center for Medicare and Medicaid Services (CMS) both can come to a synergy in the implementation of connected care, the possibilities are endless for the health care system.