Practice challenges of intensive care unit telemedicine.

For more than 20 years, a 100-year-old state-based system for medical licensure has not progressed commensurate with the level of 21st century technology development. Despite government and nongovernment organizational attempts, each state maintains a process of variable and time-consuming requirements with lack of reciprocity. Lack of available reimbursement for Tele-ICU physician services is thought to be a long-standing and significant barrier to the rapid adoption of Tele-ICU programs. By reviewing the reimbursement guidelines for telehealth services across all major patient financial classes, a model is discussed for developing financial projections to determine exactly what reimbursement is available for Tele-ICU programs.