Idaho Telehealth State Laws & Reimbursement Policies

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.

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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.

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Live Video

Policy
Idaho Medicaid reimburses for specific services via live video telehealth, consistent with ID Administrative Code.

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Eligible Services/Specialties
Services must be equal in quality to services provided in-person.

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Eligible Providers
Click for a list of eligible providers.

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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.

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Geographic Limits
Facility/Transmission Fee
No reimbursement for use of equipment at either the distant or originating site.

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Store-and-Forward

Policy
Idaho Medicaid will only reimburse for “two-way live video services”.

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Eligible Services/Specialties
Geographic Limits
Transmission Fee

Remote Patient Monitoring

Policy
Conditions
Provider Limitations
Other Restrictions

Email/Phone/Fax

No reimbursement for telephone, email, text or fax.

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Consent

An appropriate consent is required, which must disclose the delivery models, provider qualifications, treatment methods, or limitations and telehealth technologies.

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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.

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Miscellaneous

Click for a list of additional requirements.

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Private Payer Laws

Definitions

Requirements

Parity

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.

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Consent

A patient’s consent must be obtained.

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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.

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Cross State Licensing

Member of the following: Interstate Medical Licensure Compact, Nurse Licensure Compact.

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Miscellaneous

Click for a list of professional board telehealth-specific regulations.

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

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