Medicaid Telehealth Reimbursement
Summary
Idaho Medicaid reimburses for live video telehealth for certain providers and for specific services. There is no reference to store-and-forward or remote patient monitoring.
Definitions
Telehealth is defined as health care services delivered by a provider to a participant through the use of electronic communications, information technology, synchronous interaction between a provider at a distant site and a patient at an originating site.
Live Video
Policy
Idaho Medicaid reimburses for specific services via live video telehealth, consistent with ID Administrative Code.
Eligible Services/Specialties
Services must be equal in quality to services provided in-person.
Eligible Providers
Click for a list of eligible providers.
Eligible Sites
Telehealth services as an encounter by a facility are reimbursable if the services are delivered in accordance with the ID Medicaid Telehealth Policy.
Geographic Limits
No reference found.
Facility/Transmission Fee
No reimbursement for use of equipment at either the distant or originating site.
Store-and-Forward
Policy
Idaho Medicaid will only reimburse for “two-way live video services”.
Eligible Services/Specialties
No reference found.
Geographic Limits
No reference found.
Transmission Fee
No reference found.
Remote Patient Monitoring
Policy
No reference found.
Conditions
No reference found.
Provider Limitations
No reference found.
Other Restrictions
No reference found.
Email/Phone/Fax
No reimbursement for telephone, email, text or fax.
Consent
An appropriate consent is required, which must disclose the delivery models, provider qualifications, treatment methods, or limitations and telehealth technologies.
Out of State Providers
Providers of telehealth services must be licensed by the Idaho Board of Medicine or in the case of therapeutic consultation and crisis intervention for children’s developmental disabilities services, providers must meet staff qualifications.
Miscellaneous
Click for a list of additional requirements.
Private Payer Laws
Definitions
No reference found.
Requirements
No reference found.
Parity
No reference found.
Professional Regulation/Health & Safety
Definitions
Telehealth services means health care services provided by a provider to a person through the use of electronic communications, information technology, asynchronous store-and-forward transfer or synchronous interaction between a provider at a distant site and a patient at an originating site. Such services include, but are not limited to, clinical care, health education, home health and facilitation of self-managed care and caregiver support.
Consent
A patient’s consent must be obtained.
Online Prescribing
Prescribing physicians must have prescriber-patient relationship, which includes a documented patient evaluation adequate to establish diagnoses and identify underlying conditions and/or contraindications to the treatment.
Cross State Licensing
Member of the following: Interstate Medical Licensure Compact, Nurse Licensure Compact.
Miscellaneous
Click for a list of professional board telehealth-specific regulations.
Source: Center for Connected Health Policy
https://www.cchpca.org