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International Parkinson and Movement Disorder Society
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Step 3

Determine Financial Support

Developing a telemedicine program requires investment of your time and effort – make sure you are getting compensated appropriately.

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  Insurance Reimbursement

Physician compensation structure varies widely among countries and even within countries, and has changed in recent months due to the COVID-19 pandemic. Please verify information with local resources.

  1. In some countries, including Canada, England, and Spain, public and private health insurance reimburses telemedicine visits equivalently to in-office visits, or physician payment is not related to type of visit.
    1. US Medicare and Medicaid

As a result of the COVID19 pandemic, several important changes have been made by CMS, on a temporary and emergent basis, regarding coverage of telemedicine services. CMS has published a fact sheet that can be found here:

More information can also be found on the AAN website for guidance on using telemedicine during the COVID-19 pandemic:

Prior to the COVID-19 pandemic:

If the patient reports to a clinic in a federally designated health professional shortage area (HPSA), and from there sees a specialist at a separate location via telemedicine, Medicare will reimburse for certain CPT codes. This is especially useful if there are community neurologists or primary care providers in nearby HPSAs who frequently refer, and thus may be willing to provide clinic spaces for patients.  At this time US Medicare does not cover telemedicine visits into the home for patients with movement disorders.


Medicare Telehealth Eligibility Analyzer:

  1. Many states have parity laws requiring private payers to reimburse for telemedicine visits as they would for in-office visits. A map of states with these laws and more detailed information can be found here:

Providers and/or patients should check with their insurance policies to determine what telemedicine coverage they have.Some providers may consider doing a “prior authorization” for these services to help reduce the risk of non-payment.

  Self Pay

When insurance reimbursement for telemedicine is not available, patients may be willing to or may even prefer to pay cash for telemedicine visits. If your institution does not already have a self-pay option, or you would like to offer a discounted rate, these options should be discussed with the practice’s business manager. If the patient is a US Medicare beneficiary, they may be required to sign a waiver that they are opting out of an in-office visit which would be paid for by Medicare.

  Grant Funding

FEDERAL – Many national agencies offer funding opportunities that are amenable to telehealth research.  In the US, agencies such as the Health Services and Research Administration (HRSA) and the US Department of Agriculture (USDA) Rural Development division, among other NIH granting agencies), are open to, and often request applications for telemedicine projects.

            INSTITUTIONAL – Many hospitals have their own small grants for projects that will benefit the local community and increase access to care. Furthermore, institutions may be eager to expand telemedicine services due to the likelihood of future reimbursement.

            TECH COMPANIES – Much of the research done thus far on telemedicine has been funded by companies such as Google and Verizon

            LOCAL FOUNDATIONS – Local advocacy groups may be interested in funding projects that increase access for patients in their area

  Community Nursing Facilities and CCRCS (Continuing Care Retirement Communities)

Facilities with large numbers of patients with movement disorders may be willing to contract for telemedicine services in order to market this feature to prospective residents.


Donors, including grateful patients and families, may be motivated by the need for increased access to subspecialty care among rural and homebound patients.  Larger practices and institutions may have philanthropic divisions that can assist in identifying potential donors.

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