Ambiguities in new schedules for reimbursing digital medical services in the US must be clarified

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The US healthcare system rapidly adopted telehealth and remote monitoring services during the response to the covid-19 pandemic, possibly transforming the future of health care delivery. [1] This progress, however, may be undermined by ambiguous policies, which may challenge the implementation of digital medical services. The recently released draft 2021 Physician Fee Schedule by the Centers for Medicare & Medicaid Services (CMS) included substantial proposals to telehealth and remote physiologic monitoring services. [2,3] We examine the coverage and payment advances proposed in the 2021 Physician Fee Schedule, and discuss the potential challenges facing digital medical services in the U.S. 
Telehealth and RPM in the 2021 Medicare Physician Fee Schedule 
The proposed 2021 fee schedule seeks to make reimbursement permanent for certain telehealth services. These changes are duly categorized: Category 1 services (non-telehealth services added to the Medicare telehealth services list when the non-telehealth services are similar to existing telehealth services), Category 2 services (those that require evidence demonstrating the service improves the diagnosis or treatment of an illness), and, new this year, Category 3 services (pandemic-related temporary additions to build evidence). Emergency department telehealth visits are a notable example of Category 3 services. [2] While these constitute important advances to further expand telehealth’s scope, other aspects of the proposal pertaining …

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