OIG reviewed 191,118 Medicare paid distant-site telehealth claims, totaling $13.8 million, that did not have corresponding originating-site claims. The watchdog agency then reviewed provider supporting documentation to determine whether the services met Medicare’s requirements for reimbursement. 31% of the telehealth claims did not. Specifically:
24% were unallowable because the beneficiaries received services at nonrural originating sites
7% were billed by ineligible institutional providers
3% were for services provided to beneficiaries at unauthorized originating sites
2% were for services provided by an unallowable means of communication
1% was for a noncovered service
1% was for services provided by a physician located outside the United States
Understand Medicare telehealth requirements—including coverage, coding, and documentation rules—and ensure your telehealth program and claims comply.
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Are You Eligible for a Geographic Waiver?
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Telehealth Services Arranged Alphabetically by Code Descriptor
Telehealth Services Ordered Numerically by Code Number
Glossary of Telemedicine and Telehealth Terminology
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