Montana Telehealth State Laws & Reimbursement Policies

Medicaid Telehealth Reimbursement

Summary

Montana Medicaid reimburses for live video under some circumstances. There is no reimbursement for store-and-forward or remote patient monitoring based on the definition for telemedicine.

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Definitions

Telemedicine is the use of interactive audio-video equipment to link practitioners and patients located at different sites.

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Live Video

Policy
MT Medicaid reimburses for medically necessary telemedicine services to eligible members. Providers must be enrolled as Montana Medicaid providers.

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Eligible Services/Specialties
Healthy Montana Kids: Services provided by telemedicine are allowed for non-surgical medical services and behavioral health outpatient services.

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Eligible Providers
Click for a list of eligible providers.

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Eligible Sites
Telemedicine can be provided in a member’s residence; the distance provider is responsible for the confidentiality requirements.

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Geographic Limits
The originating and distant providers may not be within the same facility or community or have the same tax ID number.

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Facility/Transmission Fee
Click for a list of provider types that can bill an originating site fee.

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Store-and-Forward

Policy
There is no reimbursement for store-and-forward based on the definition for telemedicine restricting the service to interactive audio-video.

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Eligible Services/Specialties
Geographic Limits
Transmission Fee

Remote Patient Monitoring

Policy
There is no reimbursement for remote patient monitoring based on the definition for telemedicine restricting the service to interactive audio-video.

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Conditions
Provider Limitations
Other Restrictions

Email/Phone/Fax

Click for a list of telemedicine reimbursement restrictions.

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Consent

Out of State Providers

Providers must be licensed in the state of Montana.

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Miscellaneous

Effective Jan. 1, 2017 the new place of service code is “02”.

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Private Payer Laws

Definitions

Telemedicine means the use of interactive audio, video, or other telecommunications technology...

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Requirements

Click for a list of private payer requirements.

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Parity

Private payers are required to provide coverage for services delivered through telemedicine if the services are otherwise covered by the policy, certificate, contract, or agreement.

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Professional Regulation/Health & Safety

Definitions

Telemedicine means the practice of medicine using interactive electronic communication, information technology, or other means between a licensee in one location and a patient in another location with or without an intervening health care provider.

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Consent

Online Prescribing

Cross State Licensing

Member of the following: Interstate Medical Licensure Compact, Nurse Licensure Compact, Physical Therapy Compact.

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Miscellaneous

Click for a list of professional board telehealth-specific regulations.

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

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