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Nebraska Telehealth Laws & Reimbursement Policies

Medicaid Telehealth Reimbursement

Summary

Nebraska Medicaid reimburses for live video, store-and-forward, and remote patient monitoring under some circumstances. Reimbursement for store-and-forward is only specified for teleradiology.

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Definitions

Telehealth consultation means any contact between a client and a health care practitioner relating to the health care diagnosis or treatment of such client through telehealth. For the purposes of telehealth, a consultation includes any service delivered through telehealth.

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Live Video

Policy

Nebraska Medicaid provides coverage for telehealth at the same rate as in-person services when the technology meets industry standards and is HIPAA compliant.

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Eligible Services/Specialties

Click for a list of eligible services and specialties.

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Eligible Providers

Nebraska Medicaid-enrolled providers licensed, registered, or certified to practice in Nebraska are eligible for reimbursement.

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Eligible Sites

Health care practitioners must assure that the originating sites meet the standards for telehealth, including providing a place where the client’s right for confidential and private services is protected.

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Geographic Limits

No reference found.

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Facility/Transmission Fee

Nebraska Medicaid reimburses for transmission costs for two-way, real-time interactive communication, unless provided by an internet service provider.

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Store-and-Forward

Policy

Asynchronous service is included in the definition for telehealth in Nebraska statutes.

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Eligible Services/Specialties

Nebraska Medicaid will reimburse for tele-radiology when it meets the American College of Radiology standards for tele-radiology. There is no other reference to reimbursing for other specialties.

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Geographic Limits

No reference found.

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Transmission Fee

No reference found.

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Remote Patient Monitoring

Policy

Medicaid will reimburse for telemonitoring when requirements are met.

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Conditions

No reference found.

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Provider Limitations

No reference found.

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Other Restrictions

No reference found.

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Email/Phone/Fax

No reimbursement for telephone.

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Consent

Click for a list of consent requirements.

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Out of State Providers

Out-of-State Telehealth Services are covered in some circumstances.

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Miscellaneous

NE Medicaid does provide an outpatient cardiac rehabilitation program consisting of physical exercise or conditioning and concurrent telemetric monitoring are considered a valuable therapeutic modality. When a program is provided by a hospital to its outpatients, the service is covered as an outpatient service.

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Private Payer Laws

Definitions

Telehealth means the use of medical information electronically exchanged from one site to another, whether synchronously or asynchronously, to aid a health care provider in the diagnosis or treatment of a patient.

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Requirements

Private payers and self-funded employee benefit plans must provide, upon the request of a policyholder, certificate holder, or health care provider, a description of the telehealth and telemonitoring services covered under the relevant policy, certificate, contract, or plan.

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Parity

Private payers and self-funded employee benefit plans are prohibited from excluding a service from coverage solely because the service is delivered through telehealth and is not provided through in-person consultation or contact between a licensed health care provider and a patient.

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Professional Regulation/Health & Safety

Definitions

Uniform Credentialing Act (Licensed/Credentialed Health Professionals): Telehealth means the use of medical information electronically exchanged from one site to another, whether synchronously or asynchronously, to aid a credential holder in the diagnosis or treatment of a patient.

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Consent

No reference found.

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Online Prescribing

A physician or physician assistant may establish a provider-patient relationship through telehealth and may prescribe while using telehealth.

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Cross State Licensing

Member of the following: Interstate Medical Licensure Compact, Nurse Licensure Compact, and Compact of the Association of State and Provincial Psychology Boards.

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Miscellaneous

A stroke system of care task force shall recommend eligible essential health care services for acute stroke care provided through telehealth.

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