Telehealth Reimbursement Codes & Payment Information
Fair reimbursement for telehealth services is critically important to ensure patient access to registered dietitian nutritionists (RDNs) for medically necessary nutrition services in hospitals, clinics, and private practice. As healthcare systems transform to improve quality of care and patient outcomes, inclusion of RDNs in telehealth/all care model regulations is imperative.
Evidence is clear that patients benefit when RDN services are included in preventive care and chronic disease management. Ensuring payment models to include RDN delivered services is essential to the business models that ensure providers can offer qualified care. It is a win, win for patients and RDN providers if improved payment models are developed.
Since the beginning of the pandemic, patients and RDNs have embraced telehealth.
- In response to patient safety, many RDN providers have seen their practices move to 100% virtual. Currently, most health plans are reimbursing telehealth but have changed some of their payment policies to encourage providers and patients to use virtual care alternatives to in-person treatment. The next challenge is to ensure payment parity.
- Parity ensures payment equity regardless of the location of care. Telehealth visits are recognized as the same level of care as in-person visits and should be paid at the same rate as regular, in-person visits. Parity for RDN services is also linked to improving health equity, particularly for vulnerable New York residents with limited transportation resources.
- It is a new world taking shape in terms of the delivery of care as the implementation of virtual platforms and digital health expands. RDNs, like most healthcare providers, have invested in HIPAA-compliant platforms and digital systems to ensure safe patient care/medical nutrition therapy (MNT) access. Payment codes have now been developed which allow payment for telehealth and telephonic messaging for RDN services. The infrastructure to provide virtual services is in place, and parity in payment models will ensure it is viable and sustainable.
- NEW CODES: MNT (Medical Nutrition Therapy) Codes: 97802, 97803, 97804, G0270, G0271, S9470 HCPCS code for Nutritional counseling, dietitian visit Telehealth Codes instead of office visit: 02, or 11 and Modifier 95 for Medicare
- A dietitian providing MNT for a patient with a chronic illness, who can meet virtually and/or in person, can improve patient success by reducing barriers to care.
- If that clinician is not guaranteed payment because the patient’s insurer does not cover telehealth or even if the private payer pays substantially less solely because the visit is virtual then that dietitian is less likely to invest in/offer telehealth to their patients.
- NYSAND members must participate in education and advocacy efforts to enhance patient access to qualified nutrition providers by ensuring fair and sustainable reimbursement.
A bill A.4849 sponsored by Assemblywoman Aileen Gunther has been presented to the NY State Assembly on February 8, 2021. A same as bill, S.2990 was just introduced in the Senate and is sponsored by Senator Peter Harckham. Both bills relate to requiring services provided via telehealth to be reimbursed at the same rate as an in-person office visit.
NYSAND needs our members to support these bills by writing to your
legislators so they are passed in both Assembly and Senate and included in the budget.
Please send this letter of support (linked) via email to your Senator and Assembly representatives. Include the memo as an attachment in your email and write a brief note in the email, “As your constituent, I urge you to support the attached telehealth legislation which will help reduce healthcare costs and encourage safe and efficient health and wellness services available to your constituents.” You can also include your own personal note in the body of the email if desired.
If you don’t know your Senator or Assembly representative, please use the links below to find your representatives.
NYSAND demonstrates advocacy for Telehealth Legislation through a letter of support to Assemblymember Gunther in early March.
View the letter of support from NYSAND here: “NYSAND Supports Telehealth Legislation“