Robotic Orthopaedic Institute™


Across the USA and worldwide, Telehealth, Telemedicine and Remote Patient Monitoring have been recognized as a means to expand access to care and patient engagement in their healthcare for patients who reside in remote and rural areas. It is also a way to ensure that people who lack reliable transportation to and from our clinic can still engage with their physician and medical team. When local care does not include adequate access to specialists, certain technologies, and surgical procedures and be used and billed to insurance as covered services the same as face-to-face care.

The National Academies of Sciences, Engineering, and Medicine (formerly known as the Institute of Medicine) define access to health care as the “timely use of personal health services” to achieve the best possible health outcomes. Many people face barriers that prevent or limit access to needed health care services, which are known to increase the risk of poor health outcomes and health disparities. These barriers to health care such as lack of health insurance, poor access to reliable transportation to come to the clinic for in-person care, limited, scarce, or lack of local or nearby health care resources such as a Board-Certified, Fellowship-trained Orthopaedic surgeon, and access to certain technologies including sports medicine, performing arts medicine and robotics-assisted joint replacement of the knee, hip and shoulder standard of care.

Robotic Orthopaedic Institute believes that continuity of care by in-person, face-to-face or telehealth is critical to enhance your treatment and follow up. Therefore, we offer telehealth, telemedicine, remote patient monitoring and even remote physical therapy* from within our clinic. 

Telehealth consultations for NEW PATIENTS

ROI Telehealth

New Patients who have not yet had a face-to-face encounter with our practitioners can establish a relationship with our providers prior to a face-to-face visit and surgery. 

Prior to surgery, patients should arrive into St George, Utah, the day before surgery to meet with their surgeon in person. 

How to schedule a telehealth appointment

It’s easy to schedule a telehealth appointment with our staff. Simply call (435) 423-3378 and speak with the scheduling coordinator to arrange your appointment. 

We will email the new patient paperwork to complete prior to your appointment. You’ll need a printer to print these forms and a scanner or copier to make digital copies of the forms to return them to us. Alternatively, you may send them by postal mail, but please allow enough time for them to be received, reviewed and scanned into your new medical record prior to your appointment.  The address will be on the forms for both email and postal mail return.

If you are contemplating surgery of any kind on any body part, it is necessary for us to receive x-rays or MRI reports and images. Ask your imaging provider to send us an online link to your imaging studies or to send us a CD to the address listed below in the footer of this page. They may fax us the imaging or laboratory results report to 435-523-3376.”

Out of State Telehealth

Prior to the COVID-19 pandemic, states typically required providers to be licensed in the state(s) where they were practicing. In response to the pandemic, nearly all states provided temporary waivers of these requirements. State-by-state flexibilities varied, but many states allowed out-of-state providers to practice in state without a license if they were licensed and in good standing in another state. These waivers enabled providers from across the United States to deliver care to patients in other states via telehealth at a time when many patients were seeking remote care to avoid exposure to COVID-19 and health systems and practices were experiencing severe provider workforce shortages. 

In January 2022, Center for Medicare and Medicaid Services (CMS) released “CARES Act Telehealth Expansion: Trends in Post-Discharge Follow-Up and Association with 30-Day Readmissions for Hospital Readmissions. This report assessed the impact of telehealth on post-discharge follow-up and hospital readmission rates among Medicare beneficiaries based on claims data from April 1, 2019 – September 30, 2020. The report found that:

  • Telehealth utilization varied based on beneficiaries’ socioeconomic characteristics, with higher utilization for post-discharge telehealth visits among dually eligible beneficiaries or those living in areas with greater social deprivation.
  • Use of telehealth for post-discharge follow-up contributed to lower 30-day readmissions when compared to beneficiaries who had no post-discharge follow-up visit, but slightly higher readmission rates relative to those who had an in-person follow-up visit.


Dr Hicken is licensed in Utah, Nevada, and Idaho. Craig Degen is licensed in Utah and Nevada. 

A handful of states, including Florida and New Jersey, have established new out-of-state telehealth registries that enable providers licensed and in good standing in other states to register and deliver care via telehealth to state residents. We are not registered in these states, and therefore, cannot provide telehealth to patients residing in those states. 

Alaska, Vermont, and Virginia introduced legislation that would allow health care providers licensed, certified or registered in another state to provide services via telehealth to patients in state if specific criteria are met.

Kentucky, New Jersey, and Oregon states introduced bills that would enable providers licensed in the state in which their patients are located to deliver telehealth services without being physically present in the state.  Maryland and Vermont introduced bills that would require the creation of a commission or regulatory system to support and guide state actions related to out-of-state providers delivering care via telehealth.

Telehealth / Telemedicine Terminology

“Telehealth” means the use of information and communications technologies, including telephones, remote patient monitoring devices, or other electronic means, to support clinical health care, provider consultation, patient and professional health-related education, public health, health administration, and other services.  Many of our patients who reside outside of Southern Utah elect to use telehealth for initial consultations with Dr .Hicken, and also use telehealth for post-surgical follow up visits. 

  • Synchronous audio/ visual (e.g., a real-time video call with Skype or FaceTime, Duo, Doxy, etc.),
  • Synchronous telephone (real-time voice call only), or
  • Asynchronous (e.g., email communication, use of online patient portal).

Telemedicine” means the delivery of a health care service using electronic communications, information technology, or other electronic or technological means to bridge the gap between a health care provider who is located at a distant site and a patient who is located at an originating site, either with or without the assistance of an intervening health care provider. “Telemedicine” does not include the use, in isolation, of audio-only telephone conversation, electronic mail, instant messaging, phone text, or facsimile transmission.

Telehealth and Telemedicine Pricing

New Patient Telehealth and Telemedicine Remote Monitoring prices are determined by the method used between clinician and patient, and the degree of medical decision making complexity.  Please call 435-523-3378 to inquire about the exact price and code that will be submitted for your telehealth appointment.

For Medicare, Veteran’s Administration and Medicaid, the standards are set for telehealth visits billed to  these programs are paid at the same Medicare Fee-for-Service (FFS) rate as an in-person visit during the COVID-19 public health emergency. After the COVID-19 public health emergency has been declared “ended”.

For insured patients other than Medicare, VA and Medicaid, a discounted rate may be applied as set forth in a participating provider agreement.

For cash pay patients who will pay in full, in advance  for their telehealth services, the price is the same, but a discount of 40% may is available.

About pricing and billing:

In most cases, telehealth / telemedicine visits and/or remote patient monitoring services are charged similar to their corresponding face-to-face office and remote monitoring services. This means that if your surgery included 90-days of follow up care at no cost to you, and you elect to use telehealth, where medically appropriate, the telehealth visits are also included at no additional charge in that 90-day follow up. Not all surgery procedures include 90 days of follow up at no additional cost. 

Interesting facts: Compared to follow-up after hospitalizations among beneficiaries aged 65-84 years, younger beneficiaries (<65 years) and those aged 85 and older had a slightly higher use of telehealth. 

Social Determinants of Health (SDOH) have a major impact on people’s health, well-being, and quality of life. Examples of SDOH include:

  • Safe housing, transportation, and neighborhoods
  • Racism, discrimination, and violence
  • Education, job opportunities, and income
  • Access to nutritious foods and physical activity opportunities
  • Polluted air and water
  • Language and literacy skills

*Remote physical therapy sessions are available from Toolson Physical Therapy, a separate corporation under separate ownership, located within our clinic.

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