Michigan Telehealth State Laws & Reimbursement Policies

Medicaid Telehealth Reimbursement

Summary

Michigan Medicaid reimburses for live video telemedicine for certain healthcare professionals, for patients located at certain originating sites for specific services. There is no reimbursement for store-and-forward or remote patient monitoring.

Telemedicine Michigan Summary

Definitions

Live Video

Policy
Live video telemedicine is reimbursed, and should primarily be used when travel is prohibitive for the beneficiary or there is an imminent health risk justifying immediate medical need for services. Where face-to-face visits are required, telemedicine services may be used in addition to the required face-to-face visit, but cannot be used as a substitute.

Telemedicine Michigan Live Video Policy

Eligible Services/Specialties
Eligible Providers
Facility/Transmission Fee
Originating site may bill for a facility fee. MDHHS will reimburse the originating site provider the lesser of charge or the current Medicaid fee screen.

Facility and Transmission Fee

Store-and-Forward

Policy

Remote Patient Monitoring

Policy

Out of State Providers

Telemedicine services must be provided by a health care professional who is licensed, registered or otherwise authorized to engage in his or her health care profession in the state where the patient is located.

Out of State Telemedicine Providers

Miscellaneous

Private Payer Laws

Definitions

“Telemedicine means the use of an electronic media to link patients with health care professionals in different locations. To be considered telemedicine, the health care professional must be able to examine the patient via a real-time, interactive audio or video, or both, telecommunications system, and the patient must be able to interact with the off-site health care professional at the time the services are provided.”

Telemedicine Michigan Private Payer Definitions

Requirements

Insurers and group or nongroup health care corporations shall not require face-to-face contact between a health care professional and a patient for services appropriately provided through telemedicine, as determined by the insurer or health care corporation.

Private Payer Telemedicine Requirements

Parity

Insurers and health care corporations must cover services appropriately provided through telemedicine, as determined by the insurer or health care corporation.

Telemedicine Michigan Parity

Professional Regulation/Health & Safety

Definitions

“Telehealth” means the use of electronic information and telecommunication technologies to support or promote long-distance clinical health care, patient and professional health-related education, public health, or health administration. Telehealth may include, but is not limited to, telemedicine. As used in this subdivision, “telemedicine” means that term as defined in section 3476 of the insurance code of 1956, 1956 PA 218, MCL 500.3476.

Professional Regulation, Health & Safety Definitions

Consent

Online Prescribing

Miscellaneous

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

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