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Editorials: POINT/COUNTERPOINT EDITORIALS |

Counterpoint: Should Tele-ICU Services Be Eligible for Professional Fee Billing? NoTele-ICU Billing. No

Stephen Hoffmann, MD
Author and Funding Information

From the Department of Internal Medicine and Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, The Ohio State University.

Correspondence to: Stephen Hoffmann, MD, The Ohio State University, 201 Davis Heart and Lung Research Institute, 473 W 112th Ave, Columbus, OH 43210; e-mail: stephen.hoffmann@osumc.edu


Financial/nonfinancial disclosures: The author has reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


© 2011 American College of Chest Physicians


Chest. 2011;140(4):849-851. doi:10.1378/chest.11-1560
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Extract

Remote monitoring of ICU patients through ICU telemedicine (tele-ICU) has increasingly gained a foothold in the United States. Most of these tele-ICUs consist of a facility-based central hub that contracts with individual hospitals to remotely cover their ICUs. These facility-based hubs then contract with physicians to enable them to provide remote coverage to the hospital. Physicians spend their shift in the “command center” and receive a direct payment from the facility (rate reported, $160-$200/h in 2007)1 independent of the type of services rendered (surveillance or intervention) to the patients being monitored. The physician is providing a service to the facility that benefits both the facility and the patients. Fundamentally, the physician is reimbursed for work by the facility (in a sense, Medicare Part A dollars) instead of by the patients (Medicare Part B dollars). This is similar to a number of physician reimbursement models that exists across the health-care system (employed model, trauma call, moonlighting arrangements, hospitalists). Currently, physicians are not able to directly bill patients for these services. There are a number of reasons why creating a professional fee billing process (ie, billing the patient) should not be considered.

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