New Medicare reimbursement uplifts telehealth care: A win for providers and families

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The US Department of Health and Human Services, through its Centers for Medicare & Medicaid Services (CMS), has unveiled a prospective CY2024 Physician Fee Schedule. This proposition carries promising implications for both telehealth clients and providers, introducing reimbursed Caregiver Training Services and signaling an enhanced horizon for platforms like PenguinSmart in delivering comprehensive and accessible telehealth care.

Underpinning this expansion of coverage are fresh codes dedicated to caregiver behavior management training and caregiver training services as part of therapy plans of care. These new codes equip treating practitioners to seamlessly integrate caregiver training as a pivotal facet of patient treatment strategies.

Matthew Kwok, co-founder of PenguinSmart, a healthTech company that provides digital solutions and online services for parent-centered early interventions, lauded this stride, stating, "Previously we could only bill for the time of speech-language pathologists (SLPs) and the child had to be present. Now there is a special code for training parents directly without the child there." While specific details like reimbursement amounts and eligible training providers (encompassing Occupational Therapists and Physical Therapists) require further clarification, this progression signifies a significant leap forward for the telehealth industry.

This development holds promise for both providers and clients. It extends the realm of parent training, empowering caregivers to directly contribute to enhancing their child's speech development. Kwok acknowledged ongoing uncertainties, noting, "It's still unclear exactly how much it will be reimbursed or who exactly can provide the training services, but this is a net win for us starting in 2024 and will make more of our service insurance-reimbursable."

For clients, the profound implication is the newfound potential to categorize these services as reimbursable. This transformative stride aligns with the evolving acknowledgment of caregivers' pivotal roles in a child's developmental journey. As this evolution permeates the telehealth landscape, providers like PenguinSmart are poised to deliver more inclusive and accessible services, ultimately fostering positive outcomes for patients and their families.


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