Missouri Telehealth Laws & Reimbursement Policies

Missouri TeleHealth Laws

Medicaid Telehealth Reimbursement

Summary

Definitions

"Telehealth" or "telemedicine", the delivery of health care services by means of information and communication technologies which facilitate the assessment, diagnosis, consultation, treatment, education, care management, and self-management of a patient's health care while such patient is at the originating site and the health care provider is at the distant site. Telehealth or telemedicine shall also include the use of asynchronous store-and-forward technology.

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Live Video

Policy
The department of social services shall reimburse providers for services provided through telehealth if such providers can ensure services are rendered meeting the standard of care that would otherwise be expected should such services be provided in-person. Reimbursement for telehealth services shall be made in the same way as reimbursement for in-person contact; however, consideration shall also be made for reimbursement to the originating site.

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Eligible Services/Specialties
Click for a list of eligible services and specialties.

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Eligible Providers
Click for a list of eligible providers.

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Eligible Sites
The department shall not restrict the originating site through rule or payment so long as the provider can ensure services are rendered meeting the standard of care that would otherwise be expected should such services be provided in-person.

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Geographic Limits
Payment for services rendered via telehealth shall not depend on any minimum distance requirement between the originating and distant site.

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Facility/Transmission Fee
Providers can bill Q3014 for the telehealth originating site facility fee.

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Store-and-Forward

Policy
Reimbursement for asynchronous store-and-forward may be capped at the reimbursement rate had the service been provided in-person.

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Eligible Services/Specialties
Geographic Limits
Transmission Fee

Remote Patient Monitoring

Policy
Subject to appropriations, the department shall establish a statewide program that permits reimbursement under the MO HealthNet program for home telemonitoring services.

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Conditions
Click for a list of eligible conditions.

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Provider Limitations
The program must ensure the home health agency or hospital shares telemonitoring clinical information with participant’s physician.

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Other Restrictions
If, after implementation, the department determines that the program established under this section is not cost effective, the department may discontinue the program and stop providing reimbursement under the MO HealthNet program for home telemonitoring services. The department shall promulgate rules and regulations to implement the provisions of this section.

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Email/Phone/Fax

Consent

Prior to the provision of telehealth services in a school, the parent or guardian of the child shall provide authorization for the provision of such service. Such authorization shall include the ability for the parent or guardian to authorize services via telehealth in the school for the remainder of the school year.

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Out of State Providers

Payment cannot be made to entities outside of the US, and US territories.

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Miscellaneous

Special documentation requirements apply.

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Private Payer Laws

Definitions

"Telehealth" or "telemedicine", the delivery of health care services by means of information and communication technologies which facilitate the assessment, diagnosis, consultation, treatment, education, care management, and self-management of a patient's health care while such patient is at the originating site and the health care provider is at the distant site. Telehealth or telemedicine shall also include the use of asynchronous store-and-forward technology.

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Requirements

Health carriers shall not deny coverage for a health care service on the basis that the health care service is provided through telehealth if the same service would be covered if provided through face-to-face diagnosis, consultation, or treatment.

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Parity

A health carrier may not exclude an otherwise covered health care service from coverage solely because the service is provided through telehealth rather than face-to-face consultation or contact between a health care provider and a patient.

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Professional Regulation/Health & Safety

Definitions

"Telehealth" or "telemedicine", the delivery of health care services by means of information and communication technologies which facilitate the assessment, diagnosis, consultation, treatment, education, care management, and self-management of a patient's health care while such patient is at the originating site and the health care provider is at the distant site. Telehealth or telemedicine shall also include the use of asynchronous store-and-forward technology.

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Consent

Telehealth providers (including Advanced Practice Registered Nurses who providing nursing services under a collaborative practice arrangement) are required to obtain patient (or the patient’s guardian’s) consent and document consent in patient’s record.

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Online Prescribing

Prescribing or dispensing drugs without sufficient examination is prohibited.

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Cross State Licensing

In order to treat patients in this state through the use of telemedicine or telehealth, health care providers shall be fully licensed to practice in this state and shall be subject to regulation by their respective professional boards.

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Miscellaneous

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

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