PEDIATRICS Vol. 119 No. 3 March 2007, pp. 655 (doi:10.1542/peds.2006-3693)
LETTER TO THE EDITOR |
Payment for Telephone Care: From Policy to Practice: In Reply
Sanford M. Melzer, MD, MBAMedical Administration
Children's Hospital & Regional Medical Center
Seattle, WA 98105-0371
for the 2005–2006 AAP Section on Telephone Care
As Dr Sterkel correctly points out, the issue of payment for telephone care as addressed in a recently published American Academy of Pediatrics (AAP) policy statement1 is of great importance to pediatricians. Although pediatric practice entails a great deal of telephone care, physicians in many other medical specialties also experience high demands for telephone care and are concerned that these services, which entail medical decision-making, practice expense, and malpractice risk, are rarely paid.
Over the past several years, there has been increasing support from the AAP and other specialty societies including the American College of Physicians and the American Academy of Family Physicians to revise the existing set of Current Procedural Terminology (CPT) codes under which telephone care services may be reported and paid by private and government payors. The AAP, through the Section on Telephone Care and its Committee on Coding and Nomenclature and with the strong support of the American Academy of Family Physicians and the American College of Physicians, has played a key leadership role in developing a new set of CPT codes for telephone care and other "non–face-to-face" services, including online medical evaluation and management (E/M) services.
These efforts have resulted in significant progress toward revising the existing system of payment for telephone care. At its October 2006 meeting, the American Medical Association's CPT panel approved 4 new codes for non–face-to-face care, including 3 new codes for telephone care and a new code for online E/M services.
The new telephone codes, which are time based, will replace the existing telephone care codes in the case management section of the CPT manual. These codes may be used to report a telephone E/M service provided by a physician to an established patient, parent, or guardian that did not originate from a related E/M service provided within the previous 7 days or lead to an E/M service or procedure within the next 24 hours or soonest available appointment.
The other new non–face-to-face CPT code may be used to report an online E/M service provided by a physician using the Internet or similar electronic communications network to an established patient, guardian, or health care provider that did not relate to a related E/M service provided within the previous 7 days.
Physicians around the country recently participated in a survey sponsored by the American Medical Association's Relative Value Scale Update Committee, which will be used to determine the value involved in delivering these non–face-to-face services within the resource-based relative value unit (RB-RVU) system.
The development of new CPT codes for non–face-to-face care represents an important step that supports the delivery of patient care in an increasingly "connected" practice environment. The AAP can be proud of its members for their leadership and advocacy in these efforts.
REFERENCE
- American Academy of Pediatrics, Section on Telephone Care and Committee on Child Health Financing. Payment for telephone care.
Pediatrics. 2006;118
:1768
–1773
[Abstract/Free Full Text]
PEDIATRICS (ISSN 1098-4275). ©2007 by the American Academy of Pediatrics
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