Medicaid Telehealth Reimbursement
Summary
Live video telemedicine is covered for distant site providers enrolled in Louisiana Medicaid. There is no reimbursement for the originating site.
Definitions
“Telemedicine is the use of medical information exchanges from one site to another via electronic communications to improve a recipient’s health. Electronic communication means the use of interactive telecommunications equipment that includes, at a minimum, audio and video equipment permitting two-way, real time interactive communication between the patient at the originating site, and the physician or practitioner at the distant site.”
Live Video
Policy
Louisiana Medicaid reimburses the distant site for services provided via telemedicine.
Eligible Services/Specialties
Louisiana Medicaid reimburses for “services provided via an interactive audio and video telecommunications system.”
Eligible Providers
The distant site provider must be enrolled as a Louisiana Medicaid provider to receive reimbursement for covered services.
Eligible Sites
No reference found.
Geographic Limits
No reference found.
Facility/Transmission Fee
Louisiana Medicaid only reimburses the distant site provider.
Store-and-Forward
Policy
Louisiana Medicaid will not provide reimbursement for store-and-forward based upon the definition of “telemedicine” which describes telemedicine as including “audio and video equipment permitting two-way, real time interactive communication” therefore excluding store-and-forward.
Eligible Services/Specialties
No reference found.
Geographic Limits
No reference found.
Transmission Fee
No reference found.
Remote Patient Monitoring
Policy
Click for a list of specific policies for remote patient monitoring.
Conditions
Health status monitoring: May be beneficial to individuals with congestive heart failure, diabetes or pulmonary disease.
Provider Limitations
Click for a list of provider limitations.
Other Restrictions
Click for a list of additional restrictions.
Email/Phone/Fax
No reference found.
Consent
No reference found.
Out of State Providers
No reference found.
Miscellaneous
The recipient’s record at both the originating and distant site should reflect that the service was provided using telemedicine.
Private Payer Laws
Definitions
No reference found.
Requirements
Reimbursement must be made to the originating site physician if he/she is physically present during the exam and interact with the distant-site physician.
Parity
Originating-site physician fees shall be at least 75 percent of the normal fee for an intermediate office visit.
Professional Regulation/Health & Safety
Definitions
Click for a list of professional board definitions.
Consent
Physicians must inform telemedicine patients of the relationship between the physician and patient, and the role of any other health care provider with respect to management of the patient. The patient may decline to receive telemedicine services and withdraw from such care at any time.
Online Prescribing
Click for a list of online prescribing requirements.
Cross State Licensing
A telemedicine license may be issued to out-of-state physicians, as long as they hold a full and unrestricted license in another state or U.S. territory.
Miscellaneous
Click for a list of professional board telehealth-specific regulations.
Source: Center for Connected Health Policy
https://www.cchpca.org