Medicaid Telehealth Reimbursement
Maryland Medicaid covers live video telehealth conducted by specific providers and specific originating sites.
Reimbursement for telehealth is required for services appropriately delivered through telehealth and may not exclude from coverage a health care service solely because it is through telehealth.
Covered Services – Somatic and behavioral health services: Providers must contact the participant’s healthchoice MCO or Beacon Health Option with questions regarding prior authorization requirements for telehealth services.
MD Medicaid does not cover store-and-forward. However, dermatology, ophthalmology and radiology are excluded from definition of store-and-forward. They do reimburse for these services according to COMAR 10.09.02.07.
Remote Patient Monitoring
The originating site must obtain consent. If the participant is unable to provide consent, the medical record must contain in writing an explanation as to why the participant was unable to consent to telehealth services.
Out of State Providers
Private Payer Laws
Telehealth means, as it relates to the delivery of health care services, the use of interactive audio, video or other telecommunications or electronic technology by a licensed health care provider to deliver a health care service within the scope of practice of the health care provider at a location other than the location of the patient.
Insurers must provide coverage under a health insurance policy for health care services appropriately delivered through telehealth and may not exclude coverage solely because it is provided through telehealth and not in-person.
Professional Regulation/Health & Safety
Audiologists, Hearing Aid Dispensers and Speech Language Pathologists: “Telehealth means the use of telecommunications and information technologies for the exchange of information from one site to another, for the provision of health care to an individual from a provider through hardwire or Internet connection.”