Although each state’s laws, regulations and Medicaid program policies around telehealth continue to vary, some progress has been made when it comes to reimbursement policies, according to the Center for Connected Health Policy’s (CCHP) State Telehealth Laws and Reimbursement Policies Report.
CCHP’s report, its fifth edition, covers state telehealth laws, regulations and Medicaid policies available and contains current information for all 50 U.S. states. This round of updates revealed that while each state’s laws, regulations and Medicaid program policies continue to vary, some progress has been made, with the addition of one state Medicaid program providing reimbursement for store-and-forward (which allows for the electronic transmission of medical information, such as digital images, documents, and pre-recorded videos through secure email transmission), and three states reimbursing for remote patient monitoring, although on a limited basis. Meanwhile, the report noted, some states have also moved away from requiring the patient be located in a rural area, as well as relaxed requirements on originating sites, with a few states allowing the patient’s home to serve as an originating site.
Additional noteworthy findings from the report include:
Medicaid Reimbursement:
- 48 states and Washington D.C. provide reimbursement for some form of live video in Medicaid fee-for-service.
- 13 states reimburse for store and forward delivered services. States that only provide reimbursement for tele-radiology were not counted in this number.
- 22 states reimburse for remote patient monitoring (RPM)
- 9 states reimburse for all three, although two of the policies take effect at a later date
- 31 states provide a transmission and/or facility fee
- 6 states have geographic/rural restrictions
- 23 states limit reimbursement to a specific list of facilities
Private Payer Reimbursement:
- 35 jurisdictions have laws that govern private payer reimbursement of telehealth. This number has remained constant since CCHP’s Aug. 2016 update, although some states have made modifications to their private payer law. Some laws require reimbursement be equal to in-person coverage, however not all laws mandate reimbursement.
Regarding licensure, nice state boards issue licenses related to telehealth. Two states dropped their telemedicine license and adopted the Interstate Medical Licensure Compact last year. Eighteen states have adopted the Compact, which is an expedited licensure process.
