The Center for Connected Health Policy’s (CCHP) Fall 2020 release of the “State Telehealth Laws and Reimbursement Policies” report highlights the changes that have taken place in state telehealth policy. The report offers policymakers, health advocates, and other interested health care professionals a summary guide of telehealth-related policies, laws, and regulations for all 50 states and the District of Columbia.
While this guide focuses primarily on Medicaid fee-for-service policies, information on managed care is noted in the report if it was available. The report also notes particular areas where we were unable to find information. Every effort was made to capture the most recent policy language in each state as of September 2020. This information also is available electronically in the form of an interactive map and search tool accessible on our website cchpca.org. Consistent with previous editions, the information in the PDF file will be updated biannually, as laws, regulations and administrative policies are constantly changing. The interactive map is updated more frequently.
Please note that for the most part, states continue to keep their temporary telehealth COVID-19 emergency policies siloed from their permanent telehealth policies. These temporary policies are not included in this report. In instances where the state has made policies permanent, CCHP has incorporated those policies into this report. For information on state temporary COVID-19 telehealth policies, visit CCHP’s COVID-19 Telehealth Policy tracking webpage.
TELEHEALTH POLICY TRENDS
States continue to refine and expand their telehealth reimbursement policies though they are not treated across the board in the same manner as in-person delivered services. Limitations in regards to reimbursable modality, services and location of the patient continue to be seen. Although each state’s laws, regulations, and Medicaid program policies differ significantly, certain trends are evident. Live video Medicaid reimbursement, for example, continues to far exceed reimbursement for store-and-forward and remote patient monitoring (RPM). Reimbursement for RPM and store-andforward continue to be limited. Although telephone has been allowed as a care delivery method on a temporary basis in most states as a result of the pandemic, very few states have made telephone reimbursement permanent. Other noteworthy trends include either expanding lists of eligible providers or eliminating the list all together and allowing any enrolled Medicaid provider to be reimbursed for telehealth delivered services. Teledentistry and reimbursement for allied professionals, such as physical, occupational and speech therapists were two areas where reimbursement was noticeably expanded since CCHP’s Spring 2020 edition. Additionally, some state Medicaid programs have begun incorporating specific documentation and/or confidentiality, privacy and security guidelines within their manuals for telehealth specifically.
One new state (West Virginia), added a private payer law since Spring 2020. In recent years, laws and regulations allowing practitioners to prescribe medications through live video interactions have also increased, as well as a few states even allowing for the prescription of controlled substances over telehealth within federal limits.
A few additional significant findings include:
- Fifty states and Washington DC provide reimbursement for some form of live video in Medicaid fee-for-service.
- Eighteen state Medicaid programs reimburse for store-and-forward. However, four additional jurisdictions (HI, MS, NH, and NJ) have laws requiring Medicaid reimburse for store-and-forward but as of the creation of this edition, yet to have any official Medicaid policy indicating this is occurring.
- Twenty-one state Medicaid programs provide reimbursement for RPM. This is a decrease of two states since Spring 2020, as we saw both Washington and South Carolina eliminate their remote monitoring programs. As is the case for store-and-forward, two Medicaid programs (HI and NJ) have laws requiring Medicaid reimburse for RPM but at the time this report was written, did not have any official Medicaid policy.
- Ten state Medicaid programs (Alaska, Arizona, Maryland, Maine, Minnesota, Missouri, New York, Oregon, Texas, and Virginia) reimburse for all three, although certain limitations apply
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