These are difficult times for rheumatologists. We have seen sharp declines in face-to-face patient visits since the COVID‑19 pandemic began. Many of us have questions about the best ways to maintain employee and patient safety while keeping our practices afloat and continuing to provide optimal care.
The volunteer leaders at the ACR continue to care for patients in settings from private practices to academic centers. We are in constant contact with our rheumatologist and health professional colleagues across the U.S. to stay abreast of the evolving concerns of our community. In response to member needs and in collaboration with the tireless staff at the ACR, we have generated many resources and documents on clinical guidance, practice management, ongoing advocacy and the most up-to-date information about COVID-19. I would like to highlight some of the key points in these documents, but I also encourage you to explore them on the ACR website.
Telemedicine Challenges
The necessary rapid adoption of telemedicine by many rheumatologists over the past several months has presented both opportunities and challenges. Although this technology provides better access to care for many patients virtually, obvious inherent limitations exist. Thus, the ACR recommends telemedicine be combined with periodic in-person visits.
Earlier existing barriers to telemedicine included poor and inconsistent reimbursement, challenging Health Insurance Portability and Accountability Act (HIPAA) regulations, and requirements for licensing, credentialing, malpractice coverage and informed consent laws, which often differ among states. Fortunately, some of these barriers have been waived for the duration of this public health crisis. For example, even non-rural patients may now participate in telemedicine from their homes.
As of March 1, the Centers for Medicare & Medicaid Services (CMS) increased reimbursement for virtual audiovisual visits to match that of in-person visits. The CMS later agreed to reimburse audio-only visits at the same level, backdated to this same date. Many commercial insurers soon followed suit. We are advocating at both the regulatory and legislative level to keep these changes in place long term to make it feasible for more practitioners to offer telemedicine as a permanent component of their practices. Currently, resubmission of telemedicine claims is required for reimbursement. However, as part of our advocacy initiatives, the ACR is lobbying to correct this and asking that these claims be paid without requiring resubmission, thus reducing paperwork for providers.
Some restrictions to telemedicine still apply, particularly at the state level, and we recommend checking your state’s regulations. The ACR has been supporting legislative initiatives to help streamline telemedicine services across state lines. On the COVID-19 section of our website, we provide detailed information about telehealth service requirements, billing codes and reimbursement practices.
