Becker's Hospital Review

35 CIO / HEALTH IT Cleveland Clinic bills for less than 1% of weekly MyChart messages By Alan Condon C leveland Clinic began billing patients for electronic messages through Epic's MyChart patient portal in November. Since then, it has charged fees for responses to less than 1 percent of the 110,000 weekly emails its providers received, e New York Times reported Jan. 24. Five things to know: 1. Cleveland Clinic said its email volume doubled since 2019 due to the expansion of telemedicine and electronic health communi- cations and relaxed billing rules during the pandemic. 2. Cleveland Clinic said Medicaid patients are not charged and Medicare beneficiaries without a supplemental health plan would owe between $3 and $8, according to the report. e sys- tem's maximum charge, affecting those with high deductibles on private insurance plans or without coverage, would be $33 to $50 for each exchange. 3. Federal rules dictate that a billable message must be in response to a patient inquiry and take at least five minutes. Commercial payers have followed CMS' lead, reimbursing healthcare practic- es for physicians' emails, and may charge patients a copay. e move has opened up a new revenue stream for health systems, but some providers have raised concerns about the effects these charges could have on health equity and access to care. 4. MyChart messages declined at UCSF Health in San Francisco aer the system began billing for them, though providers rarely charge patients for them, according to a JAMA study. Aer al- lowing clinicians to decide when to bill for messages, in Novem- ber 2021, patient message threads and overall messages dropped slightly at UCSF Health. Providers only charged for about 2 per- cent of message threads, but researchers argued future studies should examine overall costs under different payment models and the effects of messaging billing on health outcomes, equity, and patient and provider experience. 5. Becker's has reported on several health systems that now charge patients for electronic messages through patient portals like MyChart, including Houston Methodist, Chicago-based North- western Medicine, Lehigh Valley Health Network in Allentown, Pa., and Renton, Wash.-based Providence. n How much 3 health systems are paying for EHR installs By Naomi Diaz H ere is how much three health systems are expected to pay for the cost of purchasing, installing and upgrading a new or current electronic health record system: Boston-based Tufts Medicine reported EHR installation costs of around $70 million in 2022. The health system uses Epic EHR, which it transitioned to Amazon Web Services in 2022. Yakima (Wash.) Valley Memorial Hospital said it will spend more than $100 million to install a new electronic health records system. The EHR vendor was not named. Altamonte Springs, Fla.-based AdventHealth first announced plans to transition to an Epic EHR system in February 2020 and said a year later the project was expected to cost around $660 million. CEO Terry Shaw reported the Epic implementation expenses for 2022 through November were $355 million. n New CPT codes added for AI, virtual reality By Giles Bruce W ith the increasing use of artificial intelligence and virtual reality in healthcare, the American Medical Association unveiled new Current Procedural Terminology codes for these services. According to a Jan. 16 AMA article, the appended Category III CPT code set that took effect in 2022 includes: Artificial intelligence — 0731T to report AI facial phenotypic analysis. — 0740T and 0741 to report AI insulin titration. — 0764T and 0765T to report AI cardiac function services — 0777T to report AI-assisted epidural placement. Virtual reality — 0770T to report VR-mediated therapy. — 0771T to 0774T to report VR procedural dissociation services. n

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