Telemedicine Facts, 2nd Edition

Key topics include:

• How telemedicine works
• Advantages of telemedicine vs in-person healthcare
• Different types of telemedicine (store-and-forward, remote patient monitoring, etc.)
• Covid-19's effect on telemedicine
• Telemedicine's relationship with Medicare and Medicaid
• State-by-state analysis of telehealth services available, restrictions on each service, and billing codes by state

New in this 2nd edition:

• Live Video Medicaid Reimbursement – 50 states and District of Columbia
  Live video is the most common type of telehealth and the most predominantly reimbursed. Every state offers some type of live video reimbursement in their Medicaid program. The reimbursement varies with some Medicaid programs, limiting the types of reimbursable services and placing additional requirements and restrictions such as provider type and originating site stipulations.
• Store-and-Forward Medicaid Reimbursement – 22 states
  Store-and-forward services are covered for reimbursement by twenty-two Medicaid Programs. Some states cover only teleradiology, and they are not included in this count. Of those covering "store-and-forward," many limit what is considered reimbursable. Some states allow store-and-forward reimbursement because of communication technology-based services (CBTS), some of which include the store-and-forward modality in its description.
• Remote Patient Monitoring Medicaid Reimbursement – 27 states
  Twenty-seven states offer some type of reimbursement for RPM in their Medicaid programs. The states that offer RPM reimbursement generally include several restrictions for using RPM. Often seen are restrictions offering reimbursement to home health agencies, restricting the clinical conditions for which symptoms can be monitored, and imposing limits on the type of monitoring device and information that can be collected. Ohio allows reimbursement only for specific remote physiologic monitoring codes modeled after CMS reimbursement.
• Transmission & Facility Fees
  Thirty-four states will reimburse for either a transmission, facility fee, or both.
• Telephone Medicaid Reimbursement – 22 states
  Telephone use reimbursement is allowed in twenty-two states for some Medicaid treatments. While it varies between states, generally they reimburse specific specialties such as mental health treatment or case management. Three states allow Medicare reimbursement for audio-only interaction.
• Facility Originating Site Restrictions -16 states
  Sixteen states restrict the "site of origin" that is covered, with several of them not allowing the home as a reimbursable site. Jurisdictions have a formal list of sites that can serve as the originating site for a telehealth encounter.
• Home Services – 30 states and District of Columbia
  Thirty states and the District of Columbia allow reimbursement of services from the home. Twenty-nine states allow reimbursement from school-based settings.
• Private Payer Laws – 43 states and the District of Columbia
  Forty-three states and DC have laws that govern private payer telehealth reimbursement policies. This area has experienced incredible growth over the past few years.
• Consent Requirements – 45 states and the District of Columbia
  Forty-five jurisdictions require a type of informed consent requirement to allow telemedicine services. What is covered often varies by state with some regulating all Medicaid service, all telehealth in general, or designated areas of treatment.