Arizona Telehealth State Laws & Reimbursement Policies
Medicaid Telehealth Reimbursement
Arizona Health Care Cost Containment System (AHCCCS) reimburses for live video for certain services delivered at specific originating sites by specific providers. They reimburse for store-and-forward for specific specialties and for remote patient monitoring for patients with chronic heart failure.
Telemedicine is “the practice of health care delivery, diagnosis, consultation and treatment and the transfer of medical data through interactive audio, video or data communications that occur in the physical presence of the member, including audio or video communications sent to a health care provider for diagnostic or treatment consultation.”
The same services are covered for store-and-forward, as for real time, except for the field of Behavioral Health Services. Real time telemedicine is the only type of reimbursement available in the field of Behavioral Health Services.
Remote Patient Monitoring
Out of State Providers
Contractors shall develop and maintain a network of providers that utilizes telemedicine to support an adequate provider network. Telemedicine shall not replace provider choice and/or member preference for physical delivery.
Private Payer Laws
“Telemedicine means the interactive use of audio, video or other electronic media for the purpose of diagnosis, consultation or treatment. Does not include the sole use of an audio-only telephone, a video-only system, a facsimile machine, instant messages or electronic mail.”
Health Care Service Organizations (HCSO) must provide coverage for specified health care services that are provided through telemedicine if the health care service would be covered were it provided through in-person consultation between the enrollee and a health care provider and provided to an enrollee receiving the service in Arizona. Only applies to specific conditions and settings.
Professional Regulation/Health & Safety
Under Arizona Statute, Public Health & Safety, "telemedicine means the practice of health care delivery, diagnosis, consultation and treatment and the transfer of medical data through interactive audio, video or data communications that occur in the physical presence of the patient, including audio or video communications sent to a health care provider for diagnostic or treatment consultation.”
Physicians are prohibited from issuing a prescription to patients without having a physical or mental health status examination to establish a provider-patient relationship. The physical or mental health status examination can be conducted during a real-time telemedicine encounter.
Cross State Licensing
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