Medicaid Telehealth Reimbursement
Summary
Massachusetts Medicaid (MassHealth) makes no reference to reimbursement of telehealth or telemedicine within their policies.
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.
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.
Eligible Services/Specialties
Click for a list of eligible services/specialties.
Eligible Providers
Click for a list of eligible providers.
Eligible Sites
No reference found.
Geographic Limits
Behavioral Health Services: There are no geographic or facility restrictions on distant or originating sites.
Facility/Transmission Fee
No reference found.
Store-and-Forward
Policy
No reference found.
Eligible Services/Specialties
No reference found.
Geographic Limits
No reference found.
Transmission Fee
No reference found.
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.
Conditions
No reference found.
Provider Limitations
No reference found.
Other Restrictions
No reference found.
Email/Phone/Fax
No reference found.
Consent
No reference found.
Out of State Providers
No reference found.
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.
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.”
Requirements
Private payers may provide coverage of telemedicine services and must be consistent with coverage for health care services provided through in-person consultations.
Parity
Private payers may provide coverage of telemedicine services.
Professional Regulation/Health & Safety
Definitions
No reference found.
Consent
No reference found.
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.
Cross State Licensing
No reference found.
Miscellaneous
No reference found.
Source: Center for Connected Health Policy
https://www.cchpca.org