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CMS-1403-FC
examination, must be made regarding the administration of
thrombolytic therapy within 3 hours of the onset of stroke
symptoms. The elements of remote stroke assessment involve
discrete interactions between physicians and patients, and
the consultative input of specialists experienced in acute
stroke treatment is considered in directing the bedside
care of the patient.
Some commenters were concerned that our proposal will
not permit the use of telehealth to treat critically ill
patients. We received comments and supporting
documentation regarding the feasibility and value of
providing consultations via telehealth to patients who are
critically ill.
Response: Consultations are already included on the
list of approved telehealth services. Our proposal not to
add critical care services (as defined by 99291 and 99292)
to the list of Medicare telehealth services does not
preclude physicians or NPPs from providing medically
necessary and clinically appropriate telehealth
consultations to patients who are critically ill. We
believe that permitting initial and follow up inpatient
consultation via telehealth will help provide greater
access to specialty care for critically ill patients
(including stroke patients). If guidance or advice is
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