Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved cms innovation center demonstration project, which requires at least 2 of the following 3 key components: an expanded problem focused h...
HCPCS code
Remote In-Home Visit for Evaluation and Management of an Established Patient (G9487)
Name of the Procedure:
Common Name(s):
- Remote In-Home Visit
- Telehealth Evaluation
Technical or Medical Terms:
- Remote Evaluation and Management
- In-Home Telehealth Exam
- Medicare-Approved CMS Innovation Center Demonstration Project
Summary
A Remote In-Home Visit is a telehealth service where a healthcare provider conducts an evaluation and management session with an established patient. The visit is conducted remotely via a secure video call, addressing at least two of three key components: an expanded problem-focused history, an expanded problem-focused examination, and medical decision-making of low complexity.
Purpose
This remote service addresses various medical conditions by allowing patients to receive medical evaluations and management in the comfort of their own homes. The goal is to improve access to care, manage chronic conditions better, and reduce the need for in-person visits, particularly for patients with mobility issues or those living in remote areas.
Indications
- Management of chronic conditions like diabetes, hypertension, and COPD.
- Follow-up visits for patients recently discharged from the hospital.
- Monitoring of treatment plans and medication management.
- Patients with mobility issues or those living in remote areas.
- Conditions requiring frequent monitoring and adjustments.
Preparation
- Ensure a stable internet connection for the video call.
- Prepare a list of current medications and recent health changes.
- Perform any necessary pre-visit diagnostic tests as instructed by your healthcare provider.
- Make sure any necessary medical records or previous test results are available for review.
Procedure Description
- Scheduling: The patient schedules the remote visit through their healthcare provider or a telehealth platform.
- Setup: On the day of the visit, the patient connects to the video call using a computer, tablet, or smartphone.
- Consultation: The healthcare provider conducts the evaluation, including an expanded problem-focused history and examination, utilizing secure telehealth technology.
Management Plan: The provider discusses the findings and creates a management plan, which may include medication adjustments, lifestyle changes, or follow-up appointments.
Tools, Equipment, or Technology Used
- Secure telehealth platform or video conferencing software.
- Computer, tablet, or smartphone with camera and microphone.
Anesthesia or Sedation
- Not applicable.
Duration
The visit typically lasts between 15-30 minutes, depending on the complexity of the patient's condition and needs.
Setting
The procedure is performed remotely, allowing the patient to be at home while the healthcare provider can be in a clinic, hospital, or their own office.
Personnel
- Primary healthcare provider (e.g., physician, nurse practitioner).
- Telehealth support staff, if needed.
Risks and Complications
- Common Risks: Technical issues such as internet connection failures.
- Rare Risks: Miscommunication due to the limitations of remote interaction.
- Management: Providers may request an in-person follow-up if they believe a comprehensive physical exam is necessary.
Benefits
- Enhanced access to healthcare.
- Convenience of receiving medical care at home.
- Reduced need for travel, saving time and costs.
- Improved management of chronic conditions through regular monitoring.
Recovery
- Not applicable as the visit is non-invasive.
- Follow the provider’s instructions for any medication or lifestyle adjustments.
- Schedule follow-up visits as recommended.
Alternatives
- In-person medical visits: More comprehensive examination but requires travel.
- Telephone consultations: Convenient but lacks visual examination.
- Online medical consultation services: Varies based on the provider and service offered.
Pros and Cons of Alternatives
In-person Visits:
- Pros: Comprehensive physical exams, immediate access to in-office diagnostics.
Cons: Requires travel, potential exposure to infectious diseases.
Telephone Consultations:
- Pros: Accessible and convenient.
- Cons: Lack of visual examinations.
Patient Experience
During the visit, the patient interacts with their healthcare provider through a video call. They should feel comfortable discussing their health concerns, similar to an in-person visit. Pain management is not typically necessary as the procedure is non-invasive, but any discomfort or concerns about their medical condition should be communicated during the consultation.