Post Date: November 16, 2018

Medicaid programs, unlike Medicare, are run by the state – as such, they are subject to state laws regarding the practice of telemedicine. Owing to this, the reimbursement of services provided via telemedicine depends largely on the policy of a particular state.

As per a recent report by the Center for Connected Health Policy, this is a brief summary of the situation for Medicaid’s telemedicine reimbursement across the United States:
46 state Medicaid programs offer coverage for live video
9 state Medicaid programs provide coverage for telemedicine services provided via store-and-forward
14 state Medicaid programs provide coverage for RPM (Remote Patient Monitoring)
Just 3 state Medicaid programs (MN, MS, AK) cover all three telemedicine types
26 state Medicaid programs reimburse a transmission or facility fee (or both).

In order to conduct thorough research on telemedicine, it is essential to have a reliable source of information.

The following are three excellent sources for keeping tabs on Medicaid’s telemedicine coverage:

The National Telehealth Policy Resource Center. They have created a highly useful interactive state-wise map of telehealth policy.
State Medicaid agency websites. If you don’t know the website for your state’s Medicaid agency, here is a complete directory.

The American Telemedicine Association. The ATA regularly tracks policy updates for telemedicine and publishes quarterly reports on the latest news and situation of state legislation for telemedicine.

You can find the latest report here.

Factors that impact Medicaid’s telemedicine reimbursement. The rules and regulations for telemedicine reimbursement are different in each state and are not always completely clear. The following are some factors that can have an impact on your reimbursement for telemedicine via Medicaid:
Eligible providers (NPs, PAs)

Health Services covered
Is cross-state medical licensing permitted?
Is a pre-existing provider-patient relationship required?
Are there any location-specific limitations on providers or patients?
The kind of fee that needs to be reimbursed (facility, transmission, or both)
CPT codes that are applicable