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Practice Exam

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Medicaid and Medicare Telehealth Payments Fails to Meet Medicare Requirements

Medicaid and Medicare Telehealth Payments Fails to Meet Medicare Requirements

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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Our experts take the guesswork out of best practices and government regulations, laying out in-depth information on Medicare and Medicaid reimbursement. Capitalize on insightful answers to readers’ questions. Get the inside scoop on coding, billing, compliance, and everything between to launch your telehealth services without a hitch.

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Ace Accurate Coding for Telemedicine and Telehealth
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