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Telehealth TopicsReimbursement


Reimbursement is one of the most challenging aspects of Telehealth. Who will reimburse for Telehealth services and what amount will be reimbursed are questions we encounter routinely. While some of our states now have laws requiring private payers to pay for the same services and at the same rate as Medicaid (called parity legislation), several others do not have these laws on the books. Some states’ private payers have agreed to reimburse for Telehealth services without the legislation being in place. Here is a snapshot of the reimbursement policies of the various states, prepared by our colleagues at the Center for Connected Health Policy, a Telehealth Resource Center that specializes in following and interpreting Telehealth policy.

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AK - Regulation - Telemedicine/Telehealth Definition

“Telemedicine means the practice of health care delivery, evaluation, diagnosis, consultation, or treatment, using the transfer of medical data through audio, video, or data communications that are engaged in over two or more locations between providers who are physically separated from the patient or from each other.”

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ID Regulation Telemedicine/Telehealth Definition

“Telehealth is an electronic real-time synchronized audio-visual contact between a consultant and participant related to the treatment of the participant. The consultant and participant interact as if they were having a face-to-face service.”
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OR State Law Telemedicine/Telehealth Definition

Oregon law requires insurers to cover telemedicine services.

“Telemedical means delivered through a two-way video communication that allows a health professional to interact with a patient who is at an originating site.”

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WA Regulation Telemedicine/Telehealth Definition

“Telemedicine means the use of tele-monitoring to enhance the delivery of certain home health skilled nursing services through:

The collection of clinical data and the transmission of such data between a patient at a distant location and the home health provider through electronic processing technologies. Objective clinical data that may be transmitted includes, but is not limited to, weight, blood pressure, pulse, respirations, blood glucose, and pulse oximetry;
The provision of certain education related to health care services using audio, video, or data communication instead of a face-to-face visit.”

“Telehealth means providing physical therapy via electronic communication where the physical therapist or physical therapist assistant and the patient are not at the same physical location.”

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Federation of State Medical Boards

The Federation of State Medical Boards recently released its proposal for creation of an Interstate Licensure Compact for Physicians.
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MT State Law Telemedicine/Telehealth Definition

“Telemedicine means the practice of medicine by a physician located outside the state, who performs an evaluative or therapeutic act relating to the treatment or correction of a patient's physical or mental condition, ailment, disease, injury, or infirmity, and who transmits that evaluative or therapeutic act into Montana through any means, method, device, or instrumentality under the following conditions:
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UT State Law Telemedicine/Telehealth Definition

"Digital health service means the electronic transfer, exchange, or management of related data for diagnosis, treatment, consultation, educational, public health, or other related purposes.”
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WY State Law Telemedicine/Telehealth Definition

"Telemedicine means the practice of medicine by electronic communication or other means from a physician in a location to a patient in another location, with or without an intervening health care provider.”
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