California Telehealth Laws & Reimbursement Policies

Medi-Cal reimburses for select services via live video. Medi-Cal will also reimburse store-and-forward for certain CPT/HCPCS codes. Specific CPT/HCPCS codes are outlined in the Medi-Cal manual. As of January 2019, Medi-Cal is also reimbursing for codes G0071, G2010 and G2012.

Telehealth [according to the Telehealth Advancement Act of 2011] “is the mode of delivering health care services and public health utilizing information and communication technologies to facilitate the diagnosis, consultation, treatment, education, care management and self-management of a patient’s health care while the patient is at the originating site and the health care provider is at the distant site.”

Medi-Cal does not reimburse for telephone calls, electronic mail messages or facsimile transmissions.

Provider must obtain oral consent from the patient and document it in the patient record.

No reference found.

Medi-Cal covers telehealth to the extent services are allowable and reimbursed according to the department’s telehealth manual in the California Children’s Services Program (CCS), Genetically Handicapped Person’s Program (GHPP) and Child Health and Disability Prevention Program (CHDP).

“Telehealth means the mode of delivering health care services and public health via information and communication technologies to facilitate the diagnosis, consultation, treatment, education, care management, and self-management of a patient's health care while the patient is at the originating site and the health care provider is at a distant site. Telehealth facilitates patient self-management and caregiver support for patients and includes synchronous interactions and asynchronous store-and-forward transfers.”

Private payers cannot require that in-person contact occur before payment is made for covered telehealth services, subject to contract terms and conditions. Health plans cannot limit the settings where services are provided. Settings are still subject to contract terms and conditions.

Private payers cannot require that in-person contact occur before covering a telehealth delivered service, but it is subject to the terms and conditions of the contract.

“Telehealth means the mode of delivering health care services and public health via information and communication technologies to facilitate the diagnosis, consultation, treatment, education, care management, and self-management of a patient's health care while the patient is at the originating site and the health care provider is at a distant site. Telehealth facilitates patient self-management and caregiver support for patients and includes synchronous interactions and asynchronous store–and-forward transfers.”

The originating site provider must obtain and document verbal or written patient consent prior to service delivery.

Providers are prohibited from prescribing or dispensing dangerous drugs or dangerous devices on the Internet without an appropriate prior examination and medical indication.

No reference found.

Click for a list of professional regulations with telehealth-specific standards.