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Massachusetts Telehealth Laws & Reimbursement Policies

Medicaid Telehealth Reimbursement

Summary

Massachusetts Medicaid (MassHealth) makes no reference to reimbursement of telehealth or telemedicine within their policies.

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Definitions

Behavioral Health Services: Telehealth is the use of electronic communication and information technologies to provide or support clinical care at a distance. The delivery of services through telehealth involves the use of secure interactive audio and video telecommunications systems that permit two-way, real-time communication between a patient and a provider.

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Live Video

Policy

Behavioral Health Services: Telehealth is a modality of treatment, not a separate covered service. Providers are not required to deliver services via telehealth.

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Eligible Services/Specialties

Click for a list of eligible services/specialties.

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Eligible Providers

Click for a list of eligible providers.

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Eligible Sites

No reference found.

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Geographic Limits

Behavioral Health Services: There are no geographic or facility restrictions on distant or originating sites.

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Facility/Transmission Fee

No reference found.

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Store-and-Forward

Policy

No reference found.

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Eligible Services/Specialties

No reference found.

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Geographic Limits

No reference found.

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Transmission Fee

No reference found.

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Remote Patient Monitoring

Policy

In the FY 2014 State Budget, MA appropriates funds for the reimbursement of telehealth remote patient monitoring provided by home health agencies as a service to clients reimbursable through Medicaid, as long as it is for short term reimbursement.

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Conditions

No reference found.

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Provider Limitations

No reference found.

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Other Restrictions

No reference found.

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Email/Phone/Fax

No reference found.

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Consent

No reference found.

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Out of State Providers

No reference found.

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Miscellaneous

Behavioral Health Services: A provider may prescribe Schedule II controlled substances via telehealth only after conducting an initial in-person examination of the patient. Ongoing in-personal examinations are required every three months for the duration of the prescription.

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Private Payer Laws

Definitions

“Telemedicine as it pertains to the delivery of health care services, shall mean the use of interactive audio, video or other electronic media for the purpose of diagnosis, consultation or treatment. ‘Telemedicine’ shall not include the use of audio-only telephone, facsimile machine or e-mail.”

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Requirements

Private payers may provide coverage of telemedicine services and must be consistent with coverage for health care services provided through in-person consultations.

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Parity

Private payers may provide coverage of telemedicine services.

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Professional Regulation/Health & Safety

Definitions

No reference found.

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Consent

No reference found.

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Online Prescribing

Prior to any e-prescribing, there must be a physician-patient relationship that conforms to certain minimum norms and standards of care, which includes taking a medical history, conducting an appropriate exam, and recording the results.

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Cross State Licensing

No reference found.

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Miscellaneous

No reference found.

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