Starting teledermatology

Telemedicine allows dermatologists to deliver care to patients remotely using technology. For years, dermatologists have used telemedicine to evaluate patients in remote areas, where a trip to the practice may have taken hours. Now, dermatologists and patients alike are discovering the benefits of teledermatology, even for those with easy access to care. In the age of digital health and smartphones apps, cameras and video chats are commonplace. This makes telemedicine easier than ever, but it also sets patient expectations for remote options.

Teledermatology services can be performed in one of two ways

There are two kinds of encounters in teledermatology, and they are often used for different methods. Understanding the distinction is important both for your teledermatology practice and for reimbursement and coding. See the Academy’s position statement (PDF) for more details on the distinction and technical specifications.

Store-and-forward (asynchronous)

In this type of encounter, a dermatologic history and a set of images are collected at the originating site and transmitted electronically for review by the dermatologist. In turn, the dermatologist provides guidance to the referring physician or the patient.

Live-interactive (synchronous)

Live-interactive teledermatology takes advantage of videoconferencing as its core technology. Participants are separated in space but interact in real time. By convention, the site where the patient is located is referred to as the originating site and the site where the consultant is located is referred to as the distant site.

Methods of teledermatology used by Academy members

CMS suspended some requirements around teledermatology during the COVID-19 public health emergency (PHE). See our COVID-19 teledermatology resources for more information on telehealth flexibilities before and after the PHE. However, dermatologists report that they will continue to use telemedicine after the PHE.

Projected teledermatology use after the COVID-19 PHE

Workflow templates

The Academy has prepared workflow templates to help you understand a typical teledermatology encounter. Access one version for solo or small private practices. Another version offers guidance for academic and multispecialty practices (PDF).

Patient guidance

If your patient has questions about preparing for a telemedicine appointment, you can use our email template (Word) to offer brief guidance. The email template links to fuller Academy guidance to help patients prepare. You can also send patients to staging.aad.org/telemedicine to reach the guide. Finally, you can download and use our patient consent form (PDF).

Compliance

If your practice is considering adding teledermatology service, the following compliance issues must be addressed prior to implementation:

• Sign business associate agreements (BAAs) with the telemedicine vendor and any other vendors who will have access to protected health information (PHI) and ensure the telemedicine vendor and technology you are using follow HIPAA requirements. Among other requirements, the technology must encrypt PHI during transmission.

• Consult the Academy’s teledermatology position statement (PDF) to ensure you are following appropriate and standard care when consulting with a teledermatology case.

• Teledermatology reimbursement rules are set by Medicare and individual private payers. Learn more about teledermatology reimbursement & coding.

• Are you curious to learn more about telehealth licensure coverage across different states and territories? Check state law regarding the provision of telemedicine services, including those of the state where the patient resides. Learn more on licensures and telehealth specific exceptions per state.

• The Consolidated Appropriations Act (CAA) of 2023 extended many of the telehealth flexibilities from the PHE including no geographic restrictions for patients. However, dermatologists must still follow the state licensure laws of the state where the patient is located at the time of visit. Review the cross-state licensing requirements for more information.

• Review the AMA’s issue brief on telehealth licensure and emerging state models (PDF).

• Avoid risks of discrimination when providing telehealth services to patients. Patients with disabilities and limited English proficiency should have access to telehealth services without fear of discrimination and practices offering these services should provide the necessary accommodations. Learn more about compliance with the Americans with Disabilities Act.

• Make sure you also check with your malpractice carrier before getting started.

Additional Academy resources