Journal
TELEMEDICINE AND E-HEALTH
Volume 28, Issue 6, Pages 912-916Publisher
MARY ANN LIEBERT, INC
DOI: 10.1089/tmj.2021.0229
Keywords
telemedicine; telehealth; reimbursement; policy; economics
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This study used the Resource-Based Relative Value Scale structure as a guideline to compare the practice expenses of in-person practice and scaled virtual practice, providing a basis for discussing the differential reimbursement for virtual visits.
Background: There has been much recent discussion about the reimbursement of telehealth virtual visits. Advocates argue strongly for payment parity with in-person encounters, whereas payers insist that telehealth visits should be reimbursed at a lower value.Methods: Using the Resource-Based Relative Value Scale structure as a guideline (where physician compensation is divided into categories: time/medical decision making/malpractice expense and practice expense), we developed a framework to examine the difference in practice expense of an in-person practice compared with a scaled virtual practice.Results: We found that for current procedural terminology (CPT) code 99213, the total relative value unit (RVU) for a virtual visit would be 1.62. The in-office RVU for CPT code 99213 is 2.09.This difference could serve as the basis for a rational discussion on differential reimbursement for virtual visits.
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