Hawaii Telehealth State Laws & Reimbursement Policies

Medicaid Telehealth Reimbursement

Summary

Hawaii Medicaid (Med-QUEST) reimburses for live video. Although their statute prohibits HI Medicaid from placing any restrictions on originating sites, regulations creating restrictions on the types or originating site eligible for reimbursement and their geographic location still exist in Hawaii Rules.

Hawaii Telehealth Summary

Definitions

"Telehealth" means the use of telecommunications services, as defined in section 269‑1, to encompass four modalities: store-and-forward technologies, remote monitoring, live consultation, and mobile health; and which shall include but not be limited to real-time video conferencing-based communication, secure interactive and non‑interactive web-based communication, and secure asynchronous information exchange, to transmit patient medical information, including diagnostic-quality digital images and laboratory results for medical interpretation and diagnosis, for the purpose of delivering enhanced health care services and information while a patient is at an originating site and the health care provider is at a distant site. Standard telephone contacts, facsimile transmissions, or e-mail text, in combination or by itself, does not constitute a telehealth service for the purposes of this section."

Hawaii Telehealth Definitions

Live Video

Policy
Hawaii Medicaid is required under statute to reimburse telehealth equivalent to reimbursement for the same services provided via face-to-face contact.

Hawaii Telehealth Live Video Policy

Eligible Services/Specialties
GT, GQ or 95 modifiers must be used. See Attachment A for full list of CPT codes that are “prime candidates” for telehealth services. Distant site providers should use the 02 Place of Service Code. Codes listed in Attachment A are considered prime candidates for telehealth reimbursement.

Hawaii Telehealth Eligible Services and Specialities

Eligible Providers
No reference found.
Eligible Sites
Geographic Limits
Facility/Transmission Fee
No reference found.

Store-and-Forward

Policy
Hawaii Medicaid and private payers are required to cover appropriate telehealth services (which includes store-and-forward) equivalent to reimbursement for the same services provided in-person.

Hawaii Telehealth Store-and-Forward Policy

Eligible Services/Specialties
Federally Qualified Health Centers: Telemedicine-based retinal imaging and interpretation is not a covered service for PPS reimbursement. A face-to-face encounter with a member by an ophthalmologist or optometrist is eligible for PPS reimbursement, regardless of whether retinal imaging or interpretation is a component of the services provided.

Hawaii Telehealth Eligible Services and Specialities

Geographic Limits
No reference found.
Transmission Fee
No reference found.

Remote Patient Monitoring

Policy
Hawaii Medicaid and private payers are required to cover appropriate telehealth services (which includes store-and-forward and remote patient monitoring) equivalent to reimbursement for the same services provided in-person.

Hawaii Telehealth Remote Patient Monitoring Policy

Conditions
No reference found.
Provider Limitations
No reference found.
Other Restrictions
No reference found.

Email/Phone/Fax

Consent

No reference found.

Out of State Providers

No reference found.

Miscellaneous

Private Payer Laws

Definitions

"Telehealth" means the use of telecommunications services, as defined in section 269‑1, to encompass four modalities: store-and-forward technologies, remote monitoring, live consultation, and mobile health; and which shall include but not be limited to real-time video conferencing-based communication, secure interactive and non‑interactive web-based communication, and secure asynchronous information exchange, to transmit patient medical information, including diagnostic-quality digital images and laboratory results for medical interpretation and diagnosis, for the purpose of delivering enhanced health care services and information while a patient is at an originating site and the health care provider is at a distant site. Standard telephone contacts, facsimile transmissions, or e-mail text, in combination or by itself, does not constitute a telehealth service for the purposes of this section."

Hawaii Telehealth Private Payer Law Definitions

Requirements

Parity

Professional Regulation/Health & Safety

Definitions

"Telehealth" means the use of telecommunications services, as defined in section 269‑1, to encompass four modalities: store-and-forward technologies, remote monitoring, live consultation, and mobile health; and which shall include but not be limited to real-time video conferencing-based communication, secure interactive and non‑interactive web-based communication, and secure asynchronous information exchange, to transmit patient medical information, including diagnostic-quality digital images and laboratory results for medical interpretation and diagnosis, for the purpose of: delivering enhanced health care services and information while a patient is at an originating site and the physician is at a distant site; establishing a physician-patient relationship; evaluating a patient; or treating a patient.

Hawaii Telehealth Professional Regulation Definitions 

Consent

No reference found.

Online Prescribing

Cross-State Licensing

A licensed out-of-state practitioner of medicine or surgery can utilize telemedicine to consult with a Hawaii licensed physician or osteopathic physician as long as they don’t open an office or meet with patients in the state; the HI licensed provider retains control of the patient; the laws and rules relating to contagious diseases are not violated.

Hawaii Telehealth Professional Regulation Cross-State Licensing 

Miscellaneous

Source: Center for Connected Health Policy
https://www.cchpca.org

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