Doctors see potential revenue boost under Medicare changes, telehealth

Primary care physicians stand to earn additional revenue starting Jan. 1 under Medicare's new fee schedule for care coordination of chronically ill patients and for using certain telehealth services. 

To bill for the $40.40 per member per month fee, physicians must offer some type of 24/7 access, a minimum of 20 minutes per month of clinical team time, a creation of care plan, coordinate community-based services and agree to manage hospital, emergency department and home care services. 

Several doctors in metro Detroit interviewed by Crain's believe some provisions of the 2015 Medicare fee schedule — that also includes expansion of billable telehealth services — have the potential to add to practice revenue and improve continuity of care.

Rose Ramirez, M.D., a family practice doctor in Grand Rapids, said the Medicare payment has some strings attached, but most physicians who operate patient-centered medical homes will be able to comply. 

"We applaud any effort to reimburse physicians for all the time they put into taking care of patients," said Ramirez, who is president-elect of the Michigan State Medical Society.

Medicare payment codes also have been expanded to include seven new telehealth services. They include annual wellness visits, psychoanalysis, psychotherapy and prolonged evaluation and management services. 

"This is long overdue," said Ramirez. "It will be a tool used to communicate with patients who live in remote rural areas and maybe are too sick to come into the office." 

Ramirez said her practice will set up a quiet room with a computer and video camera to conduct telehealth consultations.