A temporary procedural code for billing, developed and released by the American Medical Association, may increase physicians' interest in performing online consultations with patients

Questions about reimbursement, liability and security have made many physicians wary about embracing e-health initiatives such as conducting online medical evaluations for patients. However, a coding option for billing, coming from their professional organization, may make doctors think twice, observers say.

"This may be a catalyst for moving reluctant physicians and practices forward," said Robert Tennant, senior policy adviser for the Medical Group Management Association, an Englewood, Colo.-based professional association with 19,000 members.

"Right now, there's very little ROI for a physician practice that adds online consultations. But if you can show physicians that they're going to get paid and they're going to save time, they'll be more interested."

The other half of the equation is nudging health plans into backing approaches that would pay physicians for online consultations. The new code might provide that impetus, too, Tennant said.

"It's good for health plans, too, because they'll pay considerably less for an e-mail than for an office visit," he said.

The new code, part of the AMA's Current Procedural Terminology (CPT) codes for online medical evaluations (0074T) is one of a group of temporary reimbursement codes for emerging technologies and services.

Released in January to give payers and providers time to add it to their information systems, the code becomes official with Medicare on July 1 and may be adopted by other insurers, if they choose.

The code covers online evaluation and management provided by a physician in response to an established patient's request. The fact that a patient and physician have an established care relationship is important to the AMA, whose guidelines for online consultations emphasize that the same type of protocols need to be met online as in a physician's office.

AMA's CPT editorial panel approved the new code after receiving two proposals for an online consultation code. One proposal came from Medem, a for-profit company owned by six medical societies, including the AMA, and other investors.