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 in your state
Michigan Telehealth State Laws & Reimbursement Policies
Medicaid Telehealth Reimbursement
Summary
Definitions
“Telemedicine is the use of telecommunication technology to connect a patient with a health care professional in a different location.”
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.
Eligible Services/Specialties
Click for a list of eligible services and specialties.
Eligible Providers
Physicians and practitioners are eligible to be distant site providers.
Eligible Sites
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.
Store-and-Forward
Policy
Telecommunication systems using store-and-forward technology are not included in MI Medicaid’s telemedicine policy.
Remote Patient Monitoring
Policy
No reference found.
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.
Miscellaneous
No reimbursement for remote access for surgical procedures, and use of robotics.
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.”
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.
Parity
Insurers and health care corporations must cover services appropriately provided through telemedicine, as determined by the insurer or health care corporation.
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.
Consent
Patient consent for Telemedicine Michigan must directly or indirectly be obtained by a health care professional utilizing telehealth.
Online Prescribing
Providers must have an existing physician-patient relationship
Miscellaneous
The Department required to study the use of telemedicine to perform competency examinations by forensic psychiatrists.
Source: Center for Connected Health Policy
https://www.cchpca.org