Massachusetts Telehealth Laws & Reimbursement Policies

Massachusetts Telehealth Laws

Medicaid Telehealth Reimbursement

Summary

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

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Facility/Transmission Fee

Store-and-Forward

Policy
Eligible Services/Specialties
Geographic Limits
Transmission Fee

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
Provider Limitations
Other Restrictions

Email/Phone/Fax

Consent

Out of State Providers

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

Consent

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

Miscellaneous

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

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