Medicaid Reimbursement

The Center for Telehealth and e-Health Law (CTeL) completed a 50 state survey which reviewed each state’s telehealth reimbursement policies.  CTeL’s research found that 45 states have some type of reimbursement for services provided via telehealth.

There are many factors that states use to determine the scope of coverage for telehealth applications, such as the quality of equipment, type of services to be provided, and location of providers (e.g., remote rural sites).

The Centers for Medicare and Medicaid Services (CMS) requires that reimbursement for Medicaid-covered services, including those with telehealth applications, must also satisfy federal requirements of efficiency, economy, and quality of care.  With this in mind, states are encouraged to use the flexibility inherent in federal law to create innovative payment methodologies for services that incorporate telehealth technology.

For example, states covering medical services utilizing telehealth may reimburse both the provider at the hub site for the consultation and the provider at the spoke site for the office visit.  States also have the flexibility to reimburse any additional cost (i.e., technical support, line-charges, depreciation on equipment, etc.) associated with the delivery of a covered service by electronic means as long as the payment is consistent with the requirements of efficiency, economy, and quality of care.  These add-on costs can be incorporated into the fee-for-service rates or separately reimbursed as an administrative cost by the state.  If they are separately billed and reimbursed, the costs must be linked to a covered Medicaid service.

Click Here CTeL 50 State Survey on Medicaid Telehealth and Telehomecare Policies  (Part I  Alabama to Kansas)

Click Here CTeL 50 State Survey on Medicaid Telehealth and Telehomecare Policies  (Part II  Kentucky to North Dakota)

Click Here CTeL 50 State Survey on Medicaid Telehealth and Telehomecare Policies  (Part III  Oklahoma to Wyoming)