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Telemedicine can be defined as using technological equipment as an avenue in which providers can meet with their patients. Usually done through online video calls–whether through phone or computers, telemedicine has created a new outlet for primary healthcare providers to evaluate, diagnose and treat patients remotely. The popularity and need for telemedicine arose during the COVID-19 pandemic, serving as a way for the less acutely ill patients to receive health care effectively and safely. When it comes to discussing how the United States government reimburses advanced practice nurses or physicians alike for services like telemedicine, depends on each state and their laws put in place by legislature. 

According to the Department of HealthCare Services (DHCS) telehealth is considered a cost-effective alternative to health care provided in-person, particularly to underserved areas. Telehealth is not a distinct service, but a way that providers deliver health care to their patients that approximates in-person care. “DHCS’s coverage and reimbursement policies for telehealth align with the California Telehealth Advancement Act of 2011 and federal regulations. State law defines telehealth as “the mode of delivering health care services and public health via information and communication technologies to facilitate the diagnosis, consultation, treatment, education, care management, and self-management of a patient’s health care while the patient is at the originating site and the health care provider is at a distant site.” (DHCS, 2021). 

Furthermore, the details and guidelines of reimbursements in California can differ from the type of insurance the patient is under ie. Medi-Cal and Medicare. To illustrate, Medi-Cal will reimburse for telemedicine services provided through means of live video. Services must be billed with either a GT or 95 modifiers. Under both insurances Advanced Practices Nurse are eligible for Medi-Cal and Medicare reimbursements so that they meet the guidelines and regulations approval. Telemedicine, while cost effective for patients, is still revenue building for primary care providers. 


Telehealth and Telemedicine are one of the products of Information and Communication Technology (ICT) revolution that provides health services to patient remotely. According to Gogia (2020), Telehealth is a process of delivering patient-centered care healthcare services at a distance. It covers a wider range of healthcare services besides the healthcare provider-patient relationship. It also reduces the cost and discomfort associated with patients traveling and promotes easy access to specialties that can attend to timely urgent care. Telehealth promotes connection to the healthcare team that results in harmonious continuity of care. In addition to that, Telehealth incorporates the store and a forward system where patients in rural areas can have access to a radiologist, especially during non-office hours. CT scans and MRIs interpretations can be done through teleradiology companies that have an available board-certified radiologist that can interpret an image in a matter of minutes. Another positive impact of telehealth is the association with social media where patients and relatives become involved such as “Patients like me” where people of the same chronic condition can share their experiences with one another. 

On the other hand, Telemedicine is the provision of clinical care rendered by a healthcare provider using clinical processes such as teleconsultation and telediagnosis (Gogia, 2020). Telestroke is a subsystem of telemedicine and can be used when a patient comes to the emergency department (ED) and can be seen by a neurologist virtually when there is no neurologist present by using two-way audio and video connection. Wound care management is another clinical skill that can be done through telemedicine by transferring images and video using telemonitoring and video conference. Moreover, the Telehealth Extension and Evaluation Act extended Medicare pandemic health waivers for two years and will allow practitioners to prescribe controlled substances via telehealth (Smith, 2022). 

The challenge for Telehealth and Telemedicine is the constant participation of older adults as they face a challenge in participation having limited knowledge and skills in technology. Technology training programs can increase the adoption of older adults to telehealth and telemedicine in order to manage chronic diseases (Goldberg et al., 2021). Teaching them and their caregivers how to use the internet by starting them through a telephone call and guiding their way in navigating their smartphones and laptop will eventually increase their knowledge and participation in telehealth.

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