Telehealth / Telemedicine Resources

Telehealth Policies

Select region:

United States — Regulatory & Billing

Uses CPT + CMS POS/Modifiers (95/93, POS 02/10)
Telehealth often rolled into global maternity billing depending on payer
Medicare retains specific lists for telehealth-eligible services

International Telehealth Considerations

Billing may not use CPT; may be regulatory rather than fee-based
National telehealth standards vary (e.g., NHS England, Health Canada, Australian Digital Health Agency)
Data residency and cross-border imaging rules may apply
Some regions mandate local encryption, PACS integration, or CE-marked hardware

Telehealth Resources

Maternal–Fetal Medicine Telehealth

Remote Ultrasound Platforms

Remote Continuous Glucose Monitoring (CGM) Monitoring

Use case: Remote CGM monitoring supports faster insulin titration and safer follow-up between visits for gestational diabetes (GDM) and pregestational diabetes in pregnancy, by enabling structured review of CGM patterns and rapid communication of adjustments.

Practical workflow (clinic-ready)

Enroll + consent: confirm patient contact method, consent for electronic communication, and which data will be reviewed (CGM ± insulin doses/meals).
Connect data-sharing: patient links CGM/app to a clinic portal (or invites clinic) so reports can be reviewed remotely.
Set expectations: review cadence (e.g., 1–2×/week initially), response times, and what triggers urgent contact (symptoms, persistent lows, ketones, etc.).
Review standardized reports: look at time-in-range, overnight patterns, post-meal excursions, and recurrent lows; document actionable interpretation.
Communicate + adjust: send dosing changes using secure messaging/phone/video; include “if/then” instructions and when to re-check.
Document: date range reviewed, key patterns, changes made, patient instructions, and follow-up plan.

What to document (quick checklist)

Device/platform used and how data was received (portal/shared report)
Dates/times of CGM data reviewed (and whether ≥72 hours of usable data were available)
Pattern summary (overnight, fasting, postprandial, hypoglycemia patterns)
Therapy changes (insulin doses/timing, nutrition counseling points)
Patient communication (message/phone/video) and follow-up interval

Common CGM & diabetes data portals (sharing options)

System / Portal	Patient sharing	Clinician view	Notes
Dexcom Clarity clarity.dexcom.com	Share/invite clinic from app (clinic code / invitation workflow)	Clinic portal for remote trend review	Well-suited for scheduled “pattern reviews” between visits.
FreeStyle LibreView libreview.com	LibreLink / LibreLinkUp + LibreView sharing (region-specific)	Professional LibreView account dashboards/reports	Cloud reports facilitate remote review without in-office download.
Medtronic CareLink carelink.minimed.com	Link/share device data with provider via account linking	Provider access to reports once linked	Verify patient upload/connectivity requirements for your device.
Tandem Source tandemdiabetes.com	“Share Reports” / add clinic in Tandem Source	Clinic access to shared reports	Useful when pump + CGM patterns need combined review.
Aggregators (optional) Glooko • Tidepool	Patient uploads/shares multiple devices in one place (varies)	Unified reports across supported devices	Helpful for mixed-device practices; confirm supported devices and workflows.

Billing: codes & documentation essentials (U.S.)

Educational summary only—always verify AMA/CMS rules + payer policy.

Code	What it pays for (high level)	Minimum threshold(s)	Documentation “must-haves” (practical)
95251 CGM analysis	QHP analysis, interpretation, and report of CGM data (professional service)	≥72 hours of CGM data Typically billed once per calendar month	Dates of data reviewed + statement that data meets ≥72 hrs Key patterns/metrics (e.g., overnight trends, post-meal excursions, recurrent lows) Written interpretation + actionable plan (dose/timing changes, counseling, follow-up) Date-of-service = date interpretation/report completed
99454 Remote Patient Monitoring (RPM) device supply	RPM device supply + data transmission (device(s) with daily recording(s) or programmed alert(s) transmission)	Physiologic data collected on ≥16 days in a 30-day period (RPM) Only one billing practitioner for RPM per patient per 30-day period	Medical necessity/order for RPM + condition monitored Device supplied/provisioned (device type; start date) Objective transmission log showing ≥16 distinct days of data in the 30-day period Note who is billing RPM for that 30-day window (avoid duplicate billing)
99457 RPM treatment mgmt	Treatment management using RPM data (clinical staff/physician/QHP time)	≥20 minutes time in the service period At least one real-time interactive communication with patient/caregiver Note: the “16-day data” rule applies to RPM data collection, not to 99457/99458.	Time log (minutes) for RPM management work (`review data → assess → adjust plan → document`) Evidence of real-time two-way communication (date/time; phone/video; with patient/caregiver) What data were reviewed + clinical decisions/changes made Patient instructions and follow-up plan
99458 Add-on time	Add-on for additional RPM treatment management time beyond 99457	Each additional 20 minutes beyond the first 20 minutes Must be billed with 99457 (not standalone)	Separate total time accounting showing additional 20-minute blocks Same clinical content as 99457: data reviewed, decisions made, and communication as applicable Clear statement that additional time was medically necessary and part of ongoing RPM management

Tip: create a standard “RPM/CGM interpretation note” template with required fields (service period, data days, minutes, interactive communication, actions taken).

Helpful references (official / professional):

Tele-Ultrasound Platform Comparison

Platform	Primary MFM Use	Key Features	Deployment Notes
Butterfly TeleGuidance	Pocket ultrasound w/ remote guidance	Live imaging, AR probe cues, remote settings	Ideal for satellite clinics or novice scanners
GE Verisound	Tele-mentored exams on full console	Fleet mgmt, live collaboration, hub support	Best for multi-site health systems
Philips Collaboration Live	Remote consult + training, handheld+cart	Live chat, screen share, remote support	Works well for rural ↔ tertiary MFM hubs
Samsung + Vivify RPM	High-risk pregnancy remote monitoring	Vitals, care plans, device bundles	Complements imaging; not for acquisition

Telehealth Billing & CPT Overview (U.S.)

Educational summary only—verify with AMA/CMS/payers.

POS 02 Telehealth outside home
POS 10 Telehealth in home
95 audio-video | 93 audio-only
OB global billing rules differ by payer

Recommend separate printable cheat sheet per payer.