What is the criteria for a primary physician and telemedicine? Is a consent for physician services, such as radiology via telemedicine, required and can a telemedicine physician be the physician primarily responsible for a patients care?
There are two different topics here: #1 Consent for telemedicine, and #2 who can be the primary physician for an inpatient.
- The CMS Interpretive Guidance manual, or SOM does not say anything about consent for telemedicine. However, during the pandemic, when everyone got into Telehealth and CMS made it easier for payment, CMS did mandate through payment rules, rules for consent for Telehealth if you were going to bill for what they called “virtual check in.”
This would be where a patient asks a question, sends it to the physician and the question has no temporal relationship to a visit conducted the day before. If you want to bill, there may be copayments and CMS wants the patient to have informed consent.
- The CMS SOM does require each patient to be admitted under the care of a physician. They don’t specifically state this could not be a telemedicine physician, but that seems impractical. Most telemedicine is specialty care like radiology, neurology, which is then reported to an onsite physician.