Digital Medicine Payment Advisory Group

The AMA Digital Medicine Payment Advisory Group identifies barriers to digital medicine adoption and proposes comprehensive solutions on coding, payment, coverage and more.

Digital medicine presents an opportunity to improve access and to offer cost-effective medical care to a large swath of patients with varied needs. To maximize this potential, over the past several years, the CPT® Editorial Panel (Panel) has made significant progress in establishing CPT codes for digital medicine services.

These CPT codes have provided holistic coding solutions that not only account for the physician/qualified health care professional work, but also the practice expense cost of clinical staff and the software/devices used in capturing these data.

The catalyst for many of these changes has been the Digital Medicine Payment Advisory Group (DMPAG). DMPAG is a collaborative initiative—convened by AMA—that engages a diverse cross-section of nationally recognized experts. Along with the support of national medical specialties, the CPT Category I codes have gone through AMA/Specialty Society RVS Update Committee (RUC) valuation.

Increasing coverage requires a concerted effort by knowledgeable professionals as well as input, such as pertinent use cases and clinical data that demonstrate the efficiencies and clinical benefits of digital medicine.

Areas of focus for the advisory group include:

• Create and disseminate data supporting the use of digital medicine technologies and services in clinical practice.
• Review existing code sets (with an emphasis on CPT and HCPCS) and determine the level to which they appropriately capture in current digital medicine services and technologies.
• Assess and provide clinical guidance on factors that impact the fair and accurate valuation for services delivered via digital medicine.
• Provide education and clinical expertise to decision makers to ensure widespread coverage of digital medicine (e.g., telemedicine and remote patient monitoring), including greater transparency of services covered by payers and advocacy for enforcement of parity coverage laws.
• Review program integrity issues including, but not limited to, appropriate code use, and other perceived risks unique to digital medicine. Develop guidance and clarity on issues to diverse stakeholder groups.

Members are selected based on individual expertise and experience, not as a representative of a specialty society, institution, association or company.

Joseph C. Kvedar, MD, FAAD (co-chair)

Vice president, Connected Health at Harvard Partners HealthCare

Karen S. Rheuban, MD (co-chair)

Professor of pediatrics (cardiology), senior associate dean for continuing medical education and director of the Center for Telehealth, University of Virginia

Donald M. Hilty, MD, MBA 

Professor of psychiatry & behavioral sciences, UC Davis School of Medicine, chief medical officer, Heritage Oaks Health System and Universal Health Services

Peter A. Hollmann, MD

Chief medical officer, University Medicine at Brown University, Alpert Medical School, Department of Internal Medicine Faculty Practice

David J. Houghton, MD, MPH 

Chair / medical director, telemedicine & digital medicine; chief, division of movement and memory disorders; vice chair, department of neurology, Ochsner Health System

Robert Jarrin, JD

The Omega Concern, LLC

Aditi U. Joshi, MD, MSc, FACEP

Nagamed LLC, Mdisrupt, Redesign Health, Panda Health

Katharine L. Krol, MD, FSIR, FACR 

Former CPT Editorial Panel executive committee member; CPT liaison to the RUC Panel 

Demetrios L. Kouzoukas

Partner, Team8; former director (Center for Medicare) and principal deputy administrator, Center for Medicare & Medicaid Services

John Mattison, MD

Formerly chief medical information officer and assistant medical director, Kaiser Permanente

Brendan O’Leary

Independent consultant; former deputy director of the Digital Health Center of Excellence at the U.S. Food and Drug Administration (FDA)

Andrey Ostrovsky, MD

Social Innovation Ventures, former chief medical officer of the US Medicaid program

René Quashie

Vice president, digital health, Consumer Technology Association

Peter A. Rasmussen, MD, FAHA, FAANS

Medical director for distance health and associate professor of neurosurgery, Cerebrovascular Center at the Cleveland Clinic, Cleveland, Ohio

Morgan Reed

Executive director, ACT | The App Association 

Ezequiel “Zeke” Silva III, MD, FACR, RCC

Director of interventional radiology, South Texas Radiology Imaging Centers; diagnostic and interventional radiologist, South Texas Radiology Group, San Antonio, Texas, RVS Update Committee, chair

Laurel Sweeney

Principal, Access Strategies, LLC

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