Street Medicine Delivery Now Included in PA’s Medicaid Program
- The Centers for Medicare and Medicaid Services have added outreach sites and streets to its list of “Place of Service Codes for Professional Claims”, which could potentially allow for health workers to get reimbursed for services rendered in these locations. This update is seen as significant for programs like the street medicine program at Penn Medicine Lancaster General Health.
- To bill and get reimbursed for services, health workers will need to enroll patients in insurance programs like Medicaid. However, there are also limits on which health providers are eligible to bill for services. Although Pennsylvania lists doctors, certified nurse midwives, advanced practice clinicians, psychologists, and other professionals as eligible, registered nurses are not individually included.
- Despite the positive developments, there are a set of challenges for street medicine practitioners. Beyond the financial aspects, the emotional and psychological toll of providing healthcare to transient populations can be substantial. However, practitioners like Kara Cohen believe the small individual wins and the potential for the growth of street medicine provide hope and motivation.
Medicare and Medicaid Services Update “Place of Service Codes”
In October, the Centers for Medicare and Medicaid Services (CMS) added outreach sites and streets to their list of “Place of Service Codes for Professional Claims.” This includes homeless shelters, schools, offices, private homes, and mobile units.
Benefiting Street Medicine Programs
Updates to the CMS service codes are seen as beneficial to the street medicine program at Penn Medicine Lancaster General Health, according to Dr. Jeffrey Martin. The program, currently relying on funding from health system, grants, and private donations, is set to expand with new hires. Martin hopes the new reimbursements will aid these efforts.
Enrollment in Insurance Programs
However, for these services to qualify for reimbursements, health workers must enroll patients in insurance programs like Medicaid. Martin sees this as a potential barrier, but believes that with time, trust can be established and patients may feel more comfortable sharing their information.
Limited Eligibility for Reimbursements
Certain healthcare providers are excluded from reimbursements. Pennsylvania’s list includes doctors, nurse midwives, psychologists and others, but not registered nurses. Julie Dees, CEO of the Family Service Association of Bucks County whose street medicine program is staffed by registered nurses and social workers, hopes this will change in the future.
Street Medicine ‘On the Front Lines’
In Philadelphia’s Kensington neighborhood, street medicine professionals encounter patients daily who need urgent medical attention. Despite the physical, emotional, and psychological challenges, their commitment to saving lives remains strong. Kara Cohen, a street medicine professional, believes the service code updates and new insurance reimbursements will alleviate some financial burdens, enabling the street medicine field to continue growing and helping more people.
—
Read More Health & Wellness News ; US News
Leave a Comment